BACKGROUND: Eye care and assessment of the eye are critical for intensive care patients to prevent ocular complications like dry eye and corneal abrasion. However, there is no measurement tool developed for intensive care patients that examines the risks of ocular complications.
OBJECTIVE: This study aimed to develop a valid and reliable tool, the Critically Ill Patient Eye Assessment Scale (CIPEAS), for assessing the risk of ocular complications and determining the frequency of eye care.
METHODS: This study is an instrument development study. This methodological study was conducted with 151 intensive care patients in Turkey between March 2022 and March 2023. Data were collected with the Patient Information Form and the CIPEAS. The data were evaluated using SPSS 23 statistical software. AMOS 21 was used to verify the structure obtained with CFA. Exploration and confirmatory factor analyses were performed to determine the scale\'s factorial structure.
RESULTS: As a result of exploratory factor analysis, a six-item scale consisting of a single dimension was obtained, explaining 59.993% of the total variance. The fit indices of the scale were found to be χ2/SD = 2.653, GFI = 0.954, RMSEA = 0.075, NFI = 0.949 and CFI = 0.967. Cronbach\'s alpha of the scale was found to be 0.862.
CONCLUSIONS: The CIPEAS was found to be a valid and reliable assessment tool.
CONCLUSIONS: The Critically Ill Patient Eye Assessment Scale is a valid and reliable tool for Turkish society for assessing the risk of ocular complications. It is recommended for various national and international studies with different patients in intensive care units.

BACKGROUND: Identification and referral of at-risk patients from primary care practitioners (PCPs) to eye care professionals remain a challenge. Approximately 1.9 million Americans suffer from vision loss as a result of undiagnosed or untreated ophthalmic conditions. In ophthalmology, artificial intelligence (AI) is used to predict glaucoma progression, recognize diabetic retinopathy (DR), and classify ocular tumors; however, AI has not yet been used to triage primary care patients for ophthalmology referral.
OBJECTIVE: This study aimed to build and compare machine learning (ML) methods, applicable to electronic health records (EHRs) of PCPs, capable of triaging patients for referral to eye care specialists.
METHODS: Accessing the Optum deidentified EHR data set, 743,039 patients with 5 leading vision conditions (age-related macular degeneration [AMD], visually significant cataract, DR, glaucoma, or ocular surface disease [OSD]) were exact-matched on age and gender to 743,039 controls without eye conditions. Between 142 and 182 non-ophthalmic parameters per patient were input into 5 ML methods: generalized linear model, L1-regularized logistic regression, random forest, Extreme Gradient Boosting (XGBoost), and J48 decision tree. Model performance was compared for each pathology to select the most predictive algorithm. The area under the curve (AUC) was assessed for all algorithms for each outcome.
RESULTS: XGBoost demonstrated the best performance, showing, respectively, a prediction accuracy and an AUC of 78.6% (95% CI 78.3%-78.9%) and 0.878 for visually significant cataract, 77.4% (95% CI 76.7%-78.1%) and 0.858 for exudative AMD, 79.2% (95% CI 78.8%-79.6%) and 0.879 for nonexudative AMD, 72.2% (95% CI 69.9%-74.5%) and 0.803 for OSD requiring medication, 70.8% (95% CI 70.5%-71.1%) and 0.785 for glaucoma, 85.0% (95% CI 84.2%-85.8%) and 0.924 for type 1 nonproliferative diabetic retinopathy (NPDR), 82.2% (95% CI 80.4%-84.0%) and 0.911 for type 1 proliferative diabetic retinopathy (PDR), 81.3% (95% CI 81.0%-81.6%) and 0.891 for type 2 NPDR, and 82.1% (95% CI 81.3%-82.9%) and 0.900 for type 2 PDR.
CONCLUSIONS: The 5 ML methods deployed were able to successfully identify patients with elevated odds ratios (ORs), thus capable of patient triage, for ocular pathology ranging from 2.4 (95% CI 2.4-2.5) for glaucoma to 5.7 (95% CI 5.0-6.4) for type 1 NPDR, with an average OR of 3.9. The application of these models could enable PCPs to better identify and triage patients at risk for treatable ophthalmic pathology. Early identification of patients with unrecognized sight-threatening conditions may lead to earlier treatment and a reduced economic burden. More importantly, such triage may improve patients\' lives.

OBJECTIVE: To assist policy-makers in improving access to eye care in under-served areas by analysing the relationship between motivational factors affecting the uptake of task-shifting in eye care and the recruitment and retention of optometrists in remote and rural areas.
BACKGROUND: The World Health Organization recommends two key strategies in tackling preventable blindness in under-served areas: improving human resources for health and task-shifting. The relationship between task-shifting and recruitment and retention of eye care workers in under-served areas is unknown. Ghana and Scotland are two countries from different levels of economic development that have notably expanded the roles of optometrists and struggle with rural recruitment and retention.
METHODS: Motivation was explored through semi-structured interviews with 19 optometrists in Ghana and Scotland with experience in remote and rural practice. Framework analysis was used to analyse interviews, explore the relationship between task-shifting and recruitment and retention and create recommendations for policy.
RESULTS: The main motivational considerations included altruism, quality of life, learning and career opportunities, fulfilling potential, remuneration, stress of decision-making and collaboration. Motivational and demotivational factors for task-shifting and recruitment/retention shared many similar aspects.
CONCLUSIONS: Recruitment and retention in remote and rural areas require staff be incentivised to take up those positions, motivated to remain and given the adequate resources for personal and professional fulfilment. Task-shifting also requires incentivisation, motivation to continue and the resources to be productive. Many motivational factors influencing recruitment/retention and task-shifting are similar suggesting these two strategies can be compatible and complementary in improving access to eye care, although some factors are culture and context specific. Understanding optometrists\' motivation can help policy-makers improve rural recruitment and retention and plan services.

BACKGROUND: Given the growing popularity of contact lenses among female students in Saudi Arabia for various reasons including vision correction as well as aesthetic and therapeutic purposes, it is essential to understand the knowledge about them, their uses, and how to handle them, given their significance in healthcare.
METHODS: A cross-sectional study design was utilized in this research, employing data from a sample of 413 female students at the University of Bisha. The participants completed a self-administered questionnaire and were ensured anonymity.
RESULTS: The study results showed that 52.9% (n=218) had a good knowledge level while 47.1% (n=195) had poor knowledge about contact lenses use. The results established a statistically significant association between region, faculty, and study year (p<0.005) with p-values of 0.002, 0.001, and 0.005, respectively, and level of knowledge about contact lens use. There was no statistically significant association between the age of the participants and the level of knowledge about contact lens use.
CONCLUSIONS: Although there was a generally good level of awareness about contact lens use among female students, there is still insufficiency in knowledge with regard to particular aspects such as cleaning the contact lenses and contact lens cover. The study finds the need for more ocular educational sessions with ophthalmologists to increase awareness about contact lenses.

BACKGROUND: This study is part of broad-based research to determine the impact of blindness control activities in general and with special reference to the Andhra Pradesh Right to Sight Society (APRTSS) activities in the southern Indian states of Andhra Pradesh and Telangana. As part of the global \"VISION 2020: The Right to Sight\" initiative, the APRTSS was established in the undivided state of Andhra Pradesh in 2002. Since then, the APRTSS has been actively implementing the strategies of VISION 2020 to reduce visual impairment and blindness in the state.
OBJECTIVE: The availability and distribution of the eye care workforce are essential to reach the goals of VISION 2020: The Right to Sight, the global initiative to eliminate avoidable blindness. This study assessed the trends in the availability and distribution of eye health professionals and eye care infrastructure in 2 southern Indian states: Andhra Pradesh and Telangana.
METHODS: This cross-sectional study used a pretested questionnaire to gather data for the year from 2012 to 2013. Data for 2002 to 2003 were collected from available historical records. The questionnaires were pretested in a pilot study conducted before the main survey. Pretested questionnaires were administered to all eye care professionals-ophthalmologists (n=1712) and midlevel ophthalmic personnel (MLOP; n=1250)-eye care facilities with ≥10 inpatient beds or performing ≥100 cataract surgeries per annum (n=640), local nongovernmental eye care organizations (n=182), and international eye care organizations (n=10). Data were collected for 2 different time periods: the baseline year of 2002 to 2003 and the target year of 2012 to 2013. Data analysis was conducted using SPSS version 19.0.
RESULTS: The response rates were 81.1% (519/640) for eye care facilities, 96.1% (1645/1712) for ophthalmologists, and 67.6% (845/1250) for MLOP. From 2002-2003 to 2012-2013, there has been an increase in eye care facilities, from 234 to 519 (121.8%); ophthalmologists, from 935 to 1712 (83.1%); and MLOP, from 767 to 1250 (63%). The ophthalmologist:population ratio improved from 1:88,260 in 2002-2003 to 1:51,468 in 2012-2013. The MLOP:population ratio improved from 1:168,283 in 2002-2003 to 1:138,117 in 2012-2013 but still falls short of the ideal number.
CONCLUSIONS: Both southern Indian states are able to meet the requirements for ophthalmologists and eyecare infrastructure as per the goals of VISION 2020. However, the number of MLOP falls short of the ideal ratio for the population. This study has some limitations. For example, most of the data collected through questionnaires were based on self-report, which might introduce bias due to memory recall or over or under-reporting of certain information. However, this was addressed by cross-checking the collected data with information from supplementary sources.

OBJECTIVE: The prevalence of vision disorders is high among geriatric and hospital inpatient populations, yet they often go undetected, resulting in consequences such as falls or prolonged recovery time. A needs assessment study was conducted to investigate levels of vision and the potential prevalence of unmanaged/undiagnosed ocular disorders among adult inpatients in a hospital-based rehabilitation unit.
METHODS: Cross-sectional study.
METHODS: Inpatient rehabilitation units of an acute care hospital system in Ontario, Canada. Adults (n = 112) in a hospital inpatient rehabilitation unit participated from October 2018 to February 2019.
METHODS: Participants were surveyed regarding their demographic, ocular, and medical data and spectacle wear. Visual acuity, contrast sensitivity, visual fields, and stereoacuity plus the spectacle condition were directly assessed.
RESULTS: The majority (75%) were found to have reduced habitual vision while in hospital. Nearly 60% of participants reported at least some difficulty reading a newspaper or distinguishing a face or were \"not happy with their vision.\" This was despite 80% of participants reporting that they had an eye care practitioner and 70% that they had an eye examination within the last 2 years. More than half (51.8%) of the participants received the recommendation to follow up with their eye care practitioner on discharge from the hospital.
CONCLUSIONS: Reduced vision and vision disorders has a high prevalence among hospital patients in rehabilitation units and should be evaluated at or soon after hospital intake. By incorporating vision screening tools, necessary precautions may be taken to avoid possible falls and promote recovery.

UNASSIGNED: Visual impairment, which is related to many eye diseases, is a major public health problem. If detected and treated early, it can be prevented; therefore, regular use of vision services is very important.
UNASSIGNED: This study aimed to assess the proportion of utilization of eye care services and associated factors among the rural community population in southern Ethiopia.
UNASSIGNED: A community-based cross-sectional study design with a two-stage cluster random sampling technique was conducted to collect data from adults aged 40 years and above using interviewer-administered questionnaires. Kebeles were randomly selected by the lottery method, and systematic random sampling with proportional distribution was used to select the households. An adult individual was randomly selected from a household when there was more than one adult available. A binary logistic regression model was used to establish the association between eye care service utilization and the variables that might affect it.
UNASSIGNED: Of the 551 study population, 510 responded to this study, and the response rate was 92.6%. The mean age of the respondents was 52.2 years. The rate of eye care service utilization was 29% (95% confidence interval (0.25, 0.33)). The study shows that older participants, aged 65 and above (adjusted odds ratio: 4.04; 95% confidence interval (2.20, 7.43)), having previous eye problems (adjusted odds ratio: 10.04; 95% confidence interval (5.81, 17.33)), the presence of systemic illness (adjusted odds ratio: 2.52; 95% confidence interval (1.21, 5.21)), and having awareness about regular checkups (adjusted odds ratio: 11.75; 95% confidence interval (6.62, 20.84)) were found to be the predictors of eye care service utilization.
UNASSIGNED: In this study, utilization of eye care services was low. Older age, previous eye problems, systemic illness, and awareness about checkups were found to be predictors of eye care service utilization. Hence, there is a need to increase the absorption of existing ophthalmic services and create awareness of the use of ophthalmology services to reduce preventive blindness.

BACKGROUND: Improper refractive correction can be harmful to eye health, aggravating the burden of vision impairment. During most optometry clinical consultations, practitioner-patient interactions play a key role. Maybe it is feasible for patients themselves to do something to get high-quality optometry. But the present empirical research on the quality improvement of eye care needs to be strengthened. The study aims to test the effect of the brief verbal intervention (BVI) through patients on the quality of optometry service.
METHODS: This study will take unannounced standardized patient (USP) with refractive error as the core research tool, both in measurement and intervention. The USP case and the checklist will be developed through a standard protocol and assessed for validity and reliability before its full use. USP will be trained to provide standardized responses during optical visits and receive baseline refraction by the skilled study optometrist who will be recruited within each site. A multi-arm parallel-group randomized trial will be used, with one common control and three intervention groups. The study will be performed in four cities, Guangzhou and three cities in Inner Mongolia, China. A total of 480 optometry service providers (OSPs) will be stratified and randomly selected and divided into four groups. The common control group will receive USP usual visits (without intervention), and three intervention groups will separately receive USP visits with three kinds of BVI on the patient side. A detailed outcome evaluation will include the optometry accuracy, optometry process, patient satisfaction, cost information and service time. Descriptive analysis will be performed for the survey results, and the difference in outcomes between interventions and control providers will be compared and statistically tested using generalized linear models (GLMs).
CONCLUSIONS: This research will help policymakers understand the current situation and influencing factors of refractive error care quality, and then implement precise policies; at the same time, explore short and easy interventions for patients to improve the quality of optometry service.
BACKGROUND: Chinese Clinical Trial Registry ChiCTR2200062819. Registered on August 19, 2022.

To examine the eye care practice in the Mumbai Metropolitan Region (MMR).
This study consisted of primary and secondary research conducted in five zones of MMR. The primary research included interviews with the patients, eye care providers, and key opinion leaders. The secondary research included analyzing data from the professional ophthalmology societies, public health domain, and health insurance providers. We divided people into three economic classes by annual income - low (1.8 m). We analyzed the collected data to estimate the eye care demand-supply, quality of eye care, health-seeking behavior, gap in eye care delivery, and eye care expenditure.
We examined 473 key eye care facilities and interviewed 513 people. The ophthalmologist density in MMR was 80/million, and it was the highest in North MMR. Most ophthalmologists visited several facilities. Cataract surgery and glaucoma care coverage were better than other specialties; it was poor for oncology and oculoplastic services. Annual eye examination practice was poor in the low- and middle-income groups than in the high-income group (48%-50% vs. 85%). Most people preferred visiting eye care facilities within 5 km of their residence. Out-of-pocket spending was between 60% and 83%. Lower-income group people preferred public facilities.
MMR eye care needs further improvement in affordable and accessible eye care, health literacy, public health surveillance, research into the application of newer technologies to provide less-expensive home care for the elderly and minimize their hospital visits, and collection and analysis of big data to address city-specific eye health issues.

BACKGROUND: Despite the high prevalence of ocular complications in patients admitted to the intensive care unit (ICU), eye care, as an important component of the care plan, has not received much attention from nurses. To improve the quality of eye care, the challenges and concerns of ICU nurses should be studied deeply. Thus, the present study aimed at exploring the challenges faced by ICU nurses in taking care of patients admitted to the ICU.
METHODS: The present conventional qualitative content analysis study was carried out on 11 nurses and 3 head nurses selected purposefully by observing the maximum variation. The data were collected through face-to-face, in-depth, and semi-structured interviews. All data were recorded, transcribed, and analyzed using the conventional content analysis method proposed by Graneheim and Lundman (Nurse Educ Today 24:105-12, 2004). The Max Q Data software 2020 was run to record the interviews and extract codes from the transcriptions.
RESULTS: The participants\' mean age was 37.14 ± 6.41 years and their average work experience in ICU was 10.29 ± 7.63 years. The core category that emerged from data analysis was \"the lack of an evidence-based approach\", which was subdivided into five categories: \"education, the missing link\", \"nurses\' inadequate professional competence\", \"unsafe nursing care\", \"organizational requirements\", and \"difficulty in eye care evaluation\".
CONCLUSIONS: Evidence-based practice plays a minor role in the field of eye care in Iran, despite its critical importance. Thus, the Ministry of Health and Medical Education of Iran is recommended to adapt the clinical guidelines so that more attention is paid to this field.