Situation analysis of optometric education in the Eastern Mediterranean Region.

Background: There is a scarcity of research evidence on the state of optometry education in the Eastern Mediterranean Region (EMR). Aims: To assess the state of optometry education in the EMR and provide evidence for policymakers and stakeholders. Methods: Twenty-two purposively selected key academic stakeholders from 21 countries and the Eastern Mediterranean Council of Optometry completed a semi-structured optometry situation analysis questionnaire about the state of optometry education in their respective countries between August 2021 and January 2022. Data was analysed using SPSS version 25. Results: Data from 19 (86%) of the 21 countries and 1 territory were included in this analysis. Eight (36.4%) countries offered bachelor's degree programmes and 5 (22.7%) offered a diploma, 6 (27.3%) countries did not offer any optometry education. Saudi Arabia offered a doctor of optometry programme. Programmes were accredited by an accreditation body through periodic quality audits in 7 countries. Morocco had the highest average number of graduates per annum (n = 305), while Yemen had only 20. Conclusion: EMR countries differ in the number of optometry education programmes offered, as well as in their curricular competency levels and systems to monitor quality standards. There is a need for regional collaboration to harmonize and improve the quality of optometry education in the EMR.

Compliance to contact lens wear and care among Jordanian adults.

OBJECTIVE: To evaluate compliance to contact lens (CL) wear and care routines among adults in Jordan. DESIGN: A cross-sectional study using a questionnaire administered by an interviewer was conducted among adults in Jordan between the months of May and July of the year 2022. PARTICIPANTS: Adult (≥ 18 years) contact lens wearers attending work establishments, universities and shopping centers in the cities of Amman, Aqaba and Irbid in Jordan. MAIN OUTCOMES AND MEASURES: Compliance to CL wear and care in addition to CL hygiene habits were evaluated. RESULTS: A total of 834 (600 women) participants were included in the study with an age range of 18 to 55 years (average; 25.49 ± 7.75). Soft spherical CLs for myopia correction were worn by 45.6% of the sample, followed by cosmetic CLs (CCL) (43%). Highest compliance rate (99%) was calculated for not sharing CL with others and the lowest rate (24%) was for cleaning the CL case, with an average compliance rate of 72.25% for the sample with all habits surveyed. Medium compliance rates were related to following instructions of CL solution use including avoiding using expired solution or avoiding topping off. Risk factors for non-compliant behaviors included CCL wear, purchasing CL from beauty centers and being 25 years of age or younger. CONCLUSIONS AND RELEVANCE: This study which was performed in a non-clinical setting showed that women and young adults comprise the majority of CL wearers in Jordan. Participants were compliant with most CL wear and care behaviors except for cleaning the CL case and attending aftercare visits. Many CL wearers also reported purchasing lenses from beauty centers and online without consulting CL practitioners. There is a need for patient education regarding the hygiene of the CL case, and the necessity for consulting the CL practitioner for the appropriate type of CL including proper wear and care regimen.

The Scope of Optometry Practice in Jordan.

SIGNIFICANCE: The scope of optometry practice varies worldwide. Although the scope of optometry practice in Jordan is regulated, discrepancies exist in the services that optometry professionals provide. PURPOSE: This study aimed to document the scope of optometry practice in Jordan and to describe the services that optometry professionals provide, as well as to inform regulatory bodies and educators about the current situation of optometry practice and areas that require development. METHODS: A cross-sectional study was conducted using a questionnaire completed by optometry professionals working across Jordan. The questionnaire items cover the services and the tests they perform. RESULTS: Of the 714 participants, 57.8% were female and 42.2% were male, with a median age of 29 years. Participants were unevenly distributed across Jordan, with the majority working in the major cities and at optical centers (81.5%). Most participants were described as "refractionists." The most frequently provided services were basic optometric examinations, followed by community eye care services. Ocular medications were not prescribed by any participant. Reasons for not providing services were mainly attributed to license/profession regulations constraints and the service(s) not being part of the job description. About one-half of the participants have the knowledge to diagnose adnexal and anterior segment disorders. CONCLUSIONS: Optometry professionals in Jordan can provide more services if the scope of practice is expanded to match their knowledge and skills. Moreover, their nomenclature as refractionists does not represent the range of services they provide that extend beyond refraction. The concern is that optometric services are not reachable by many Jordanian populations because of the inequality of the distribution of professionals. Thus, advocacy to expand the scope of practice in Jordan is recommended.

Contact lens procurement and usage habits among adults in Sudan.

OBJECTIVE: The study aimed to assess contact lens (CL) wear and care habits among adults in Sudan. DESIGN: An observational, non-interventional, multi-center, cross-sectional study was conducted in the CL departments of all the eye hospitals and centers, and optical centers in the Khartoum State, Sudan. PARTICIPANTS: Established CL wearers residing in Khartoum State, Sudan. MAIN OUTCOMES AND MEASURES: CL wear profile, CL usage habits, hand and CL hygiene habits were assessed using an interviewer-administered questionnaire. RESULTS: The average age of the 442 participants was 24.57 (± 4.87) years. Women comprised 92% of the sample. Smoking was reported by 15.8% of the sample. 81.9% wore soft spherical CL, with 43.4% of the participants were prescribed CL on a yearly replacement schedule. Only 68.3% were prescribed CL by an eye care practitioner. Multipurpose solutions were used by 78.8% of the sample to clean CL, and by 52% to clean the lens case. Compliance rate for CL wear and care among participants was 81.1%. None of the participants reported sharing CL or CL case and rinsing the case with tap water. High compliance level was observed for overnight wear; swimming and showering with CL; handwashing before CL insertion; and cleaning of CL. Moderate compliance rates were recorded for cleaning and replacing lens case, and topping up or sharing solution. Low compliance was noted for attending after care visits. CONCLUSIONS AND RELEVANCE: CL wearers in Sudan exhibit high to moderate levels of compliance to most contact lens wear and care aspects, except for attending aftercare visits. CL practitioners in Sudan are encouraged to prescribe CL appropriate to the lifestyle and economic situation of patients and actively recommend care products. In addition, practitioners need to follow up with patients to attend aftercare appointments, where hygienic wear and care habits should be emphasized.

Digital Eye Strain and Its Risk Factors Among a University Student Population in Jordan: A Cross-Sectional Study.

BACKGROUND: Several ocular and visual symptoms resulting from use of digital devices are collectively known as digital eye strain (DES) or computer vision syndrome (CVS). Few studies exist on the prevalence of DES among young adults in the Eastern Mediterranean region. OBJECTIVES: This study aimed to investigate the prevalence and severity of digital eye strain among a university student population in Jordan.  Methods: A cross-sectional study was conducted with students enrolled at Al-Ahliyya Amman University in Jordan. DES was evaluated using the Computer Vision Syndrome Questionnaire (CVS-Q), which was filled out by students who were approached at random and signed an informed consent to participate in the study. Information related to the type, intensity of usage, settings of digital device (DD) used, and post-device use student-reported physical complaints were recorded. RESULTS: Data from 382 students were analyzed. Prevalence of CVS was 94.5%, with tearing being the most prevalent symptom (59%), while double vision was least reported by students (18.3%). DD use for more than six hours per day was reported by 55.5% of the sample size, and 30.7% of the students reported pain in joints of fingers and wrists after using a mobile phone. CONCLUSION: CVS is highly prevalent among university students in Jordan. With the increased dependence on online education due to coronavirus disease, safe habits in digital device use are recommended.

Inter-Ocular Asymmetry in Anterior Corneal Aberrations Using Placido Disk-Based Topography.

OBJECTIVE: Inter-ocular asymmetry in anterior corneal high-order aberrations has previously not been investigated. This study aims to investigate the normal range of inter-ocular asymmetry in corneal high-order aberrations (HOAs) using a Placido disk-based corneal topographer to explore the relationship between the HOA parameters of the anterior corneal for each eye individually and the refractive error. PATIENTS AND METHODS: A total of 257 subjects (98 males and 159 females) were participated, with an age range of 6 to 81 years (average of 40.2 ±17.53). Participants were divided into three groups: myopia (spherical equivalent (SEQ) of refraction ≥-0.50 D), hypermetropia (SEQ ≥+0.50 D), and emmetropia. For all patients, high-order aberrations were measured using a corneal topographer (CA.200TM; Topcon). Inter-ocular asymmetry was represented by RMS (root mean square) for three, five, and seven mm as pupil entry; aberrations for five mm pupil (vertical and oblique trefoil, vertical and horizontal comma, and primary spherical aberration) were recorded using the instrument's built-in software. RESULTS: Hypermetropes exhibit the highest inter-ocular asymmetry of all RMS values, mostly in spherical aberrations, and higher-order trefoil values. Oblique trefoil aberrations had the highest interocular asymmetry in the myopic groups. The interocular asymmetry in horizontal coma values was the highest in emmetropes and the lowest in hypermetropes. CONCLUSION: To our knowledge, this is the first observational study of inter-ocular differences in high-order aberrations of the anterior corneal surface of the human eye. This study's results could be used to establish normal values of inter-ocular asymmetry of HOAs of the anterior cornea. The use of such normal values should be investigated further to serve as a guideline for clinicians when establishing the best management route for the patient's refractive error.

University students' knowledge of corneal donation and willingness to donate corneas in the occupied Palestinian territory: a cross-sectional study.

BACKGROUND: Access to corneal transplantation is limited worldwide because of poor knowledge. Ethical, religious, and cultural barriers contribute to low rates of corneal donation. In the occupied Palestinian territory, limited information is available on factors affecting corneal donation. The aim of this study was to assess the knowledge and willingness towards corneal donation in Palestinian students. METHODS: This cross-sectional study included university students selected through convenience sampling in Nablus in the summer of 2016. The sample size was determined using the sample formulae and a 15% non-response rate. All students registered in obligatory courses were included in the study after verbal consent. Each participant was given a self-administered questionnaire consisting of 14 questions to assess knowledge, awareness, and willingness toward corneal donation. Frequencies were used for descriptive analysis, and associations were determined using multivariate analysis and χ2 test, with a p value of less than 0·05 considered significant. FINDINGS: Of the 634 students completing the questionnaire, 411 (65%) were women, 614 (97%) were Muslims, and 155 (25%) were health or medical students. 592 (93%) respondents were unaware of eye bank availability, and 407 (69%; p=0.002) of these respondents did not show willingness towards corneal donation. 431 (67%) respondents were aware of a lack in corneal donation, but 274 (64%; p=0·01) of these respondents did not show willingness towards corneal donation. 429 (68%) respondents were not willing to donate their corneas, the most common reasons being disapproval by family members and poor awareness. We found no association between sociodemographic factors and willingness was determined. INTERPRETATION: Palestinian students are aware of the lack of local cornea donation but are unwilling to donate their corneas. The study results are not representative of the entire population because of the homogeneous nature of the sample. Large efforts are needed locally to develop the eye bank infrastructure to increase knowledge and awareness relating to corneal donation. FUNDING: None.

Awareness of diabetic retinopathy among patients with type 2 diabetes mellitus in Jordan.

BACKGROUND: Increasing the level of awareness of diabetic retinopathy among individuals with type 2 diabetes mellitus is considered an important factor for early diagnosis and management of diabetic retinopathy. The aim of this study was to evaluate awareness of diabetic retinopathy among a sample of type 2 diabetes mellitus patients in Jordan. PATIENTS AND METHODS: The study period was from August to December 2015. The sample was selected randomly from patients with type 2 diabetes mellitus from the general population in three main cities of Jordan (Amman, Irbid, and Zarqa). A questionnaire was distributed to 237 participants with diabetes to assess their awareness and knowledge of diabetes and diabetic retinopathy. The questionnaire included questions to assess awareness about diabetic retinopathy, sources of knowledge about the disease, and patients' knowledge and compliance with available treatments and routine eye examinations. Patients were also questioned about the barriers that may interfere with early eye examination. RESULTS: A total of 237 participants (107 [45.1%] females and 130 [54.9%] males) with type 2 diabetes were interviewed. Mean age±SD for the study population was 54.51±10.28 years. Of the study population, 88.2% were aware that diabetes can affect the eyes and 81% reported that diabetic retinopathy can lead to blindness. Higher level of patients' awareness of diabetic retinopathy was related to higher level of formal education (p<0.05). The main source of information about diabetic retinopathy as reported by 47.3% patients was general practitioners. Patients' compliance with diabetes management was relatively high; however, their compliance with routine retinal assessment was poor, with only a total of 29.5% of participants having had an eye examination in the previous year. CONCLUSION: Awareness of the nature and consequences of diabetic retinopathy among patients with diabetes in Jordan is relatively high. However, patients' motivation to undergo retinal assessment was poor in the sample, thus hindering early diagnosis and management.

Trends of contact lens prescribing in Jordan.

PURPOSE: To evaluate contact lens prescribing trends among optometrists in Jordan. METHODS: Optometrists from 173 practices in Jordan were surveyed about prescribing contact lenses in their practice. Practitioners were required to record information for the last 10 patients that visited their practice. Demographic data such as age and gender was obtained for each patient. In addition, data relating to lens type, lens design, replacement methods and the care regime advised to each patient were recorded. Practitioners were required to provide information relating to their education and years of experience. The influence of education and experience with respect to lens prescribing trends was explored using linear regression models for the proportions of lens types fitted for patients. RESULTS: A total of 1730 contact lens fits were analyzed. The mean (±SD) age of lens wearers was 26.6 (±7.9) years, of whom 65% were female. Conventional hydrogel lenses were the most prescribed lenses, accounting for 60.3% of the fits, followed by silicone hydrogel lenses (31.3%), and rigid lenses (8.4%). In terms of lens design, spherical lenses appeared to be most commonly prescribed on monthly basis. Daily disposable lenses were second most prescribed lens modality, accounting for 20.4% of the study sample. Multi-purpose solution (MPS) was the preferred care regimen, with a prevalence of 88.1% reported in the study sample, compared to hydrogen peroxide (1-step and 2-step), which represented only 2.8% of the patients in this study. A relationship was established between the two educational groups for rigid lens prescribing (F=17.4, p<0.0001), while the experience of the optometrist was not a significant factor (F=0.4, p=0.54). CONCLUSION: This work has provides an up-to-date analysis of contact lens prescribing trends among optometrists in Jordan. Contact lens prescribing in terms of lens type, lens design, modality of wear and care regimen agree with global market trends with small variations. This report will help practitioners and the industry to detect any deficiencies in the contact lens market in Jordan, which will ease implementing current and future plans in developing contact lens practice and patient eye care in the region.

Refractive error and ocular biometry in Jordanian adults.

The aim of this study was to establish the prevalence of refractive errors in Jordanian adults of working age, and to study the ocular biometric correlates of refractive error in this population. Refractive error and ocular biometry were measured in 1093 Jordanian adult subjects aged 17-40 years to determine the prevalence of refractive error, and explore structural correlations of ametropia. Refractive error was measured using a Grand-Seiko GR-3100K closed-view infrared autorefractor. Ocular component measurements were made using A-scan ultrasonography and autokeratometry. The prevalence of myopia [spherical equivalent refraction (SER) less than -0.50 DS] and hyperopia (SER greater than +0.50 DS) was 53.71 and 5.67% respectively; 40.62% of the sample was emmetropic (refraction between +0.50 D and -0.50 D inclusive in both principal meridians). The distribution of SER was found to show marked leptokurtosis, exhibiting a peak between plano and 1 D of myopia. Corneal radius, anterior chamber depth, crystalline lens thickness, vitreous chamber depth and axial length (AL) parameters were normally distributed in the population studied. AL to corneal curvature ratio was not normally distributed, and showed marked leptokurtosis. Linear regression analysis showed that AL correlated most closely with spherical equivalent refractive error. This study has established a database of refractive error prevalence and ocular biometric correlates of ametropia in a Middle Eastern population of working age.