Optometry Commons^™

Framing Professional Programs Within Development Projects: Driving Longer Term Recognition And Integration, Diane Wallace, James Loughman, Kovin Naidoo

Articles

Background: Optometry has, over the past ten years, emerged as a profession strategically positioned to address the burden of uncorrected refractive error in developing countries. Estimates suggest that 285 million people in the world are needlessly visually impaired, mainly due to the lack of trained eye health professionals in the developing world. Development initiatives in eye care have therefore moved away from vertical, service delivery approaches to supporting the establishment of more sustainable, locally owned training programs. This research is based on one the evaluation of one such initiative known as the Mozambique Eyecare Project.

Methods: This study followed a …

Development Of Socially Responsive Competency Frameworks For Ophthalmic Technicians And Optometrists In Mozambique, Kajal Shah, Kevin Naidoo, James Loughman

Articles

There is an extreme paucity of eye care personnel and training facilities in developing countries. This study was designed to develop a comprehensive framework of competency standards for ophthalmic technicians and optometrists, in Mozambique. This could then inform the evolution of socially responsive curricula for both cadres. Methods A modified Delphi technique was used with a ten member expert panel consisting of optometrists, ophthalmic technicians and ophthalmologists, all with experience of working in a developing country context. The competencies were derived from literature, primary research data and observations from a competency development workshop. The first round involved scoring the relevance …

The Acceptability And Visual Impact Of 0.01% Atropine In A Caucasian Population, James Loughman, Daniel Ian Flitcroft

Articles

Myopia is a condition of enormous public health concern, affecting up to 2.5 billion people worldwide. The most effective treatment to prevent myopia progression is atropine but at the cost of accommodative paresis and mydriasis, necessitating the use of bifocal glasses. Low-dose atropine (0.01%) has been found to be almost as effective with significantly reduced side effects. Since there are well-recognised differences in the effect of atropine between heavily pigmented Asian eyes and Caucasian eyes, this study aimed to determine the acceptability and tolerability of 0.01% atropine (by measuring visual performance and quality of life) as a treatment for myopia …

Social Accountability: Introducing A New Dimension In Optometric Education, Vanessa Raquel Moodley, James Loughman, Kovin Naidoo

Articles

Optometry globally has undergone major developments yet poor eye health statistics remain. The World Health Organization (WHO) cites social accountability as key to addressing health challenges, urging the education sector to be more socially accountable and train according to the needs of society. A qualitative, descriptive study was used to determine the integration of social accountability within optometric education in sub-Saharan Africa. Eleven academic leaders and two student groups participated in key stakeholder interviews and focus group discussions respectively. Data was thematically analysed using interpretive content analysis. The study found that social accountability policies or practices were not formally integrated …

The Impact Of Soft Cl Wear On Corneal Curvature And Thickness And On The Outcomes Of Refractive Laser Surgery, Aoife Lloyd Mckernan

Doctoral

Introduction: Soft CL (SCL) wear can alter the cornea and have significant effects on vision quality (Hardten and Gosavi, 2009; Pflugfelder et al., 2002; Ryan and Jacob, 1996; Tseng et al., 2007). This may have implications for visual outcomes following corneal refractive surgery (CRS) (Tang et al., 2005). The time required for resolution of these SCL-induced changes can vary (González-Méijome et al., 2003a; Hashemi et al., 2008; Ng et al., 2007; Nourouzi et al., 2006; Schornack, 2003; Wang et al., 2002b). Despite this, current guidelines relating to cessation of SCL wear prior to CRS vary greatly, and are lacking in …

Diary Of A Cataract Surgeon 2045, Claire E. Mcdonnell

Articles

No abstract provided.

Rapid Assessment Of Refractive Error, Presbyopia, And Visual Impairment And Associated Quality Of Life In Nampula, Mozambique, James Loughman, Lindelwa Nxele, Cesar Faria, Stephen Thompson, Prasidh Ramson, Farai Chinanyi, Kovin S. Naidoo

Articles

Introduction: Uncorrected refractive error is the leading cause of visual impairment worldwide and leads to an impaired quality of life. This study was designed to determine the prevalence of uncorrected refractive error and presbyopia, to assess spectacle coverage, and to evaluate visual health-related quality of life among persons aged 15–50 years old in Nampula, Mozambique.

Methods: Participants were assessed using a validated rapid assessment of refractive error protocol, comprised of a demographic questionnaire, a standardized ophthalmic assessment to determine refractive status and spectacle coverage, and a modified vision-related quality of life questionnaire to assess the impact of uncorrected refractive error …

Barriers To Utilisation Of Refractive Services In Mozambique., James Loughman, Stephen Thompson, Carmen Gonzalez-Alvarez, Kovin Naidoo, Farai Chinanayi, Geoff Harris

Articles

Mozambique has a population of more than 25 million people.1 Nampula Province has just fewer than 4 million people.2 Although Mozambique is currently experiencing unprecedented economic growth rates, buoyed by the discovery of natural resources, significant challenges remain for the population, such as adequate health care, including eye health services. VISION 2020 is a global initiative to eliminate avoidable blindness by the year 2020. Its core strategies are focused on human resource development, infrastructure development, and disease control.3 The Mozambique Eyecare Project delivered a regional optometry model for Lusophone Africa, based on the VISION 2020 core strategies. A key output …

Trailmaking Test Performance Contributes To Subjective Judgment Of Visual Efficiency In Older Adults, Annalisa Setti, James Loughman, George Savva, Rose Anne Kenny

Articles

Introduction.

The determinant factors that influence self-reported quality of vision have yet to be fully elucidated. This study evaluated a range of contextual information, established psychophysical tests, and in particular, a series of cognitive tests as potentially novel determinant factors.

Materials &Methods. Community dwelling adults (aged 50+) recruited to Wave 1 of The Irish Longitudinal Study on Ageing, excluding those registered blind, participated in this study (N = 5,021). Self-reports of vision were analysed in relation to visual acuity and contrast sensitivity, ocular pathology, visual (Choice Response Time task; TrailMaking Test) and global cognition. Contextual factors such as having visited …

Visual Function And Its Relationship With Severity Of Early, And Activity Of Neovascular, Age-Related Macular Degeneration, James Loughman, Sarah Sabour-Pickett, John M. Nolan, Barbara Klein, Ron Klein, Stephen Beatty

Articles

Purpose: To investigate the relationship between visual function and severity of early age-related macular degeneration (AMD) and activity of neovascular (nv-) AMD.

Methods: The following data was collected from 66 eyes of 66 subjects with early AMD and 47 eyes of 47 subjects with active nv-AMD: corrected distance visual acuity (CDVA); contrast sensitivity (CS); glare disability (GD); and retinotopic ocular sensitivity (ROS) of the central 5° of the retina, by microperimetry. Fundus photographic grading of early AMD was performed in a masked fashion. Mean foveal thickness (MFT) was measured by spectral domain optical coherence tomography in patients with nv-AMD.

Results: …

Recruitment And Selection Strategies In Optometric Education Towards Addressing Human Resource Disparities In Sub-Saharan Africa, Vanessa Moodley, James Loughman, Kovin S. Naidoo

Articles

The dire need for eye care services and a dearth of human resources (HR) in sub-Saharan Africa motivated the setting up of new optometry programmes. However, to make a meaningful impact, geographical, gender, economic and educational disparities must additionally be addressed. A qualitative study utilizing purposive sampling to select academic leadership and students from optometry programmes in sub-Saharan Africa was conducted. Individual and focus group interviews produced data that were coded and analysed using a deductive thematic analysis approach. The themes that emerged as contributing to disparities in access through recruitment and selection were institutional barriers (student intake numbers, programme …

Refraction In Mozambique: Evaluations Of Practice And Development Of Competency Frameworks For Eye Care Personnel, Kajal Shah

Doctoral

Purpose The development of competency- based education for optometrists and mid-level eye-care personnel has been identified as an important component in the elimination of avoidable blindness and vision impairment. The Mozambique Eye care Project (MEP) is a multi-institutional collaboration, which seeks to facilitate greater access to training in eye health professions, which will ultimately contribute to providing affordable and accessible eye care within the public health system in Mozambique. An important tenet of the MEP is to develop and enhance the refraction training of all existing (ophthalmic technicians) and new eye care personnel (four-year training of optometrists and eighteen-month training …

The Development Of A Public Optometry System In Mozambique: A Cost Benefit Analysis, James Loughman, Stephen Thompson, Geoff Harris, Luigi Bilotto, Jorge Ferrao, Kovin Naidoo

Articles

Background: The economic burden of uncorrected refractive error (URE) is thought to be high in Mozambique, largely as a consequence of the lack of resources and systems to tackle this largely avoidable problem. The Mozambique Eyecare Project (MEP) has established the first optometry training and human resource deployment initiative to address the burden of URE in Lusophone Africa. The nature of the MEP programme provides the opportunity to determine, using Cost Benefit Analysis (CBA), whether investing in the establishment and delivery of a comprehensive system for optometry human resource development and public sector deployment is economically justifiable for Lusophone Africa. …

Reducing Visual Deficits Caused By Refractive Errors In School And Preschool Children: Results Of A Pilot School Program In The Andean Region Of Apurimac, Peru, Sergio Latorre-Arteaga, Diana Gil-Gonzalez, Olga Enciso, Aoife Phelan, Angel Garcia-Munoz, Johannes Kohler

Articles

Background

Refractive error is defined as the inability of the eye to bring parallel rays of light into focus on the retina, resulting in nearsightedness (myopia), farsightedness (Hyperopia) or astigmatism. Uncorrected refractive error in children is associated with increased morbidity and reduced educational opportunities. Vision screening (VS) is a method for identifying children with visual impairment or eye conditions likely to lead to visual impairment.

Objective

To analyze the utility of vision screening conducted by teachers and to contribute to a better estimation of the prevalence of childhood refractive errors in Apurimac, Peru.

Design

A pilot vision screening program in …

A Comparative Cytotoxic Evaluation Of Acrylamide And Diacetone Acrylamide To Investigate Their Suitability For Holographic Photopolymer Formulations, Dervil Cody, Alan Casey, Izabela Naydenova, Emilia Mihaylova

Articles

The comparative cytotoxic evaluation of two monomers Diacetone Acrylamide (DA) and Acrylamide (AA), used in holographic photopolymer formulations, is reported. Two normal cell lines were used: BEAS-2B and HaCaT. Cellular viability was assessed using the MTT assay for three different exposure times. A difference of two orders of magnitude is observed in the Lethal Dose (LD50) concentrations of the two monomers. Diacetone Acrylamide exhibits a significantly lower toxicity profile in comparison to Acrylamide at all exposure times. This result justifies the replacement of Acrylamide with Diacetone Acrylamide in the photopolymer formulation, with the view to reducing occupational hazard risks for …

An Economic Analysis Of The Impact Of Refractive Error In Mozambique, Stephen Thompson

Conference Papers

Mozambique eyecare project carried out in June 2013 to estimate the socio-economic benefit of an Optometry Programme by calculating the benefits of addressing refractive error in terms of productivity gained as a result of the intervention.

The Development Of A Public Optometry System In Mozambique: A Cost Benefit Analysis, Stephen Thompson, James Loughman

Articles

The economic burden of uncorrected refractive error (URE) is thought to be high in Mozambique, largely as a consequence of the lack of resources and systems to tackle this largely avoidable problem. The Mozambique Eyecare Project (MEP) has established the first optometry training and human resource deployment initiative to address the burden of URE in Lusophone Africa. The nature of the MEP programme provides the opportunity to determine, using Cost Benefit Analysis (CBA), whether investing in the establishment and delivery of a comprehensive system for optometry human resource development and public sector deployment is economically justifiable for Lusophone Africa.

Considerations In The Design Of An Eye Health Programme For Nampula, Mozambique, Aoife Phelan, Lisa O'Donoghue, Kovin Naidoo, Kathryn Saunders, James Loughman

Conference Papers

Introduction/Purpose:

There are almost twelve million children (<18 >years) in Mozambique with minimal access to eye care. [1] Annual screening of school children by teachers for uncorrected refractive error is one of the most cost effective health interventions in Sub Saharan Africa.[2] The International Agency for the Prevention of Blindness (IAPB) has recommended that child eye health interventions be incorporated into National School Health Initiatives.[3]

In view of the IAPB position this presentation sets out to identify and discuss the main considerations in the design of a child eye health strategy, for the province of Nampula, Mozambique, which aligns itself …

Considerations In The Design Of An Eye Health Programme For Nampula, Mozambique, Aoife Phelan, Lisa O'Donoghue, Kovin Naidoo, Kathryn Saunders, James Loughman

Other

Introduction/Purpose:

There are almost twelve million children (years) in Mozambique with minimal access to eye care. [1] Annual screening of school children by teachers for uncorrected refractive error is one of the most cost effective health interventions in Sub Saharan Africa.[2] The International Agency for the Prevention of Blindness (IAPB) has recommended that child eye health interventions be incorporated into National School Health Initiatives.[3]

In view of the IAPB position this presentation sets out to identify and discuss the main considerations in the design of a child eye health strategy, for the province of Nampula, Mozambique, which aligns itself with …

Evaluations Of Exit Competencies Of Optometrists In Mozambique, Kajal Shah, James Loughman

Other

Introduction: The appropriate education for eye health workers is a key determinant of sustainable eye health care systems, and the solution to avoidable blindness and visual impairment. The Mozambique Eye care Project (MEP), is developing the country's first indigenously trained optometrists using a competency-based education curriculum.

Aims: The principal aim is to evaluate the exit clinical competencies of the first optometry graduates in Mozambique and to inform the evaluation of the competency curriculum.

Methods: Using UK based competencies as a benchmark; nine final year students were examined to assess competences in six core subjects.Further information about factors relating to their …

Evaluations Of Exit Competencies Of Optometrists In Mozambique, Kajal Shah, James Loughman

Conference Papers

Introduction: The appropriate education for eye health workers is a key determinant of sustainable eye health care systems, and the solution to avoidable blindness and visual impairment. The Mozambique Eye care Project (MEP), is developing the country's first indigenously trained optometrists using a competency-based education curriculum.

Aims: The principal aim is to evaluate the exit clinical competencies of the first optometry graduates in Mozambique and to inform the evaluation of the competency curriculum.

Methods: Using UK based competencies as a benchmark; nine final year students were examined to assess competences in six core subjects.Further information about factors relating to their …

Evidence Of Lower Macular Pigment Optical Density In Chronic Open Angle Glaucoma, Estera Igras, James Loughman, Matthew Ratzlaff, Ronal O'Caoimh, Colm O'Brien

Articles

Background/aims Macular pigment (MP) plays an important role in visual function and in the protection of the retina from oxidative damage. It is not known whether glaucoma, a progressive neurodegenerative disease of the optic nerve, is associated with alterations in MP. This study was designed to investigate the relationship, if any, between the optical density of MP optical density (MPOD) and glaucoma.

Methods 40 subjects (23 males, 17 females) with open angle glaucoma (mean age 69 ±11), and 54 normal controls (23 males, 31 females) without ocular disease (mean age 66 ±11), visual acuity (VA) >6/18, were recruited, and underwent …

Suitability And Repeatability Of A Photostress Recovery Test Device, The Macular Degeneration Detector (Mdd-2), For Diabetes And Diabetic Retinopathy Assessment, James Loughman, Matthew Ratzlaff, Brittany Foerg, Paul Connell

Articles

Background: Diabetic retinopathy can result in impaired photostress recovery time despite normal visual acuity and fundoscopic appearance. The Macular Degeneration Detector (MDD-2) is a novel flash photostress recovery time device. In this study, we examine the repeatability of the MDD-2 in normal and diabetic subjects. Methods: One hundred and ninety one (90 women, 101 men) subjects were recruited and divided into 1 of the 3 study groups (normal controls, n = 40; diabetes no retinopathy, n = 98; nonproliferative diabetic retinopathy, n = 53). Photostress recovery time was measured three times in the study eye using the MDD-2, each measurement …

The Development Of A Public Optometry System In Mozambique: A Cost Benefit Analysis, Stephen Thompson, James Loughman

Conference Papers

No abstract provided.

Impact Of Computer Experience On The Viability And Repeatablity Of The Moorfields Motion Displacement Test In A Developing And Underserved African Setting, James Loughman, Carmen Gonzalez Alvarez, Gay Mary Verdon-Roe, Roger Anderson, Ramos Antonio Manuel, Kovin Naidoo

Articles

Background: The current study was designed to explore the effect of computer experience on the viability and testretest repeatability of the Moorfields Motion Displacement Test (MMDT), a novel computer-driven glaucoma screening device, in an African community setting. Methods: 164 healthy subjects were recruited from a semi-rural Mozambican environment, and stratified according to computer experience (computer naïve: n=85, computer familiar: n=79). A suprathreshold screening test algorithm was employed, and the global probability of true damage (GPTD), testing time (TT) and false positive (FP) response rate were recorded. The visual field test was conducted twice on the same eye, and results compared …

Relationship Between Fear Of Falling And Mobility Varies With Visual Function Among Older Adults, Orna Donoghue, Harriet Ryan, Eoin Duggan, Ciaran Finucane, George Sava, Hilary Cronin, James Loughman, Rose Anne Kenny

Articles

Aim: The present study examined the association between vision, fear of falling and fear-related activity restriction, and assessed the effect of vision on the relationship between fear of falling and mobility, using data from a nationally representative sample of community-dwelling adults aged ≥50 years. Methods: Participants (n = 5003) completed an interview and health assessment (including Timed Up-and-Go, vision and cognitive tests). Visual acuity and contrast sensitivity were assessed using an Early Treatment Diabetic Retinopathy Study logMAR chart and Functional Vision Analyzer, respectively. Participants self-reported their vision as excellent, very good, good, fair or poor. They were assigned to no …

Visual Performance, And It's Response To Intervention, In Subjects With Age-Related Macular Degeneration., Sarah Sabour-Pickett

Doctoral

Abstract Objectives: 1. To explore visual performance status through a range of psychophysical methods beyond corrected distance visual acuity (CDVA), in subjects with age-related macular degeneration (AMD). 2. To investigate the effects on these visual performance parameters in subjects with neovascular age-related macular degeneration (nv-AMD) and in subjects with early AMD undergoing anti-VEGF (vascular endothelial growth factor) therapy and macular carotenoid supplementation, respectively. 3. To understand the role of a supplement containing meso-zeaxanthin (MZ; the third, and currently least explored, macular carotenoid) on the augmentation of macular pigment (MP), on visual performance and on disease progression (graded according to the …

Impact Of Macular Pigment On Visual Performance, James Loughman, Peter Davison, John Nolan, Stephen Beatty

Articles

PURPOSE. To investigate changes in macular pigment optical density (MPOD) and visual performance following supplementation with different macular carotenoid formulations. METHODS. Thirty-six subjects (19 male, 17 female; mean 6 SD, age 51 6 13 years) were recruited into this single-masked placebo-controlled study, and were randomly assigned to one of the following three intervention (supplementation) groups: (1) group 1 (20 mg lutein [L] and 2 mg zeaxanthin [Z]); (2) group 2 (10 mg L, 2 mg Z, and 10 mg meso-zeaxanthin [MZ]); and group 3 (placebo). Outcomes measures included visual performance and MPOD response. Data were collected at baseline, at 3 …

Clinical Applicability Of The Macular Degeneration Detection Device (Mdd-2): A Novel Photostress Recovery Measurement Device, James Loughman, Ciara Hewitt, Claire Judge, Louise Martin, Claire Moulds, Peter Davison

Articles

Background: Diseases affecting the macula, such as age-related macular degeneration (AMD), diabetic retinopathy and central serous retinopathy can result in impaired photostress recovery time (PSRT) despite normal visual acuity and fundoscopic appearance. The MDD-2 Macular Degeneration Detection Device is a novel flash photostress recovery device. In this study, we examine the repeatability of the MDD-2 in a normal population and its suitability for incorporation into routine clinical practice. Methods: One hundred (60 female) subjects (mean age 35+-8 years; range 18 to 66 years) were recruited to partake in this study. The photostress recovery time was measured using the MDD-2 on …

Student Experience In Optometry Education In Mozambique: Initial Challenges In An International Collaborative Program, Kajal Shah

Conference Papers

Purpose:

One of the solutions to creating sustainable eye care structures is education of personnel. Mozambique currently has only 17 ophthalmologists for a population of 21 million and 34 trained Ophthalmic Technicians, the only two providers of refraction services within the local health system. There are no optometrists. The Mozambique Eyecare Project is funding the training of the country’s first optometrists at the University of Lurio in Nampula, Mozambique. Their core competencies will be evaluated with a view to creating best practise in education in a developing world environment.

Method:

This is a longitudinal evaluation of the refraction competencies …