African Vision and Eye Health (Dec 2009)
Current practices of diagnostic techniques requir- ing the use of ophthalmic drugs among KwaZulu- Natal optometrists*
Abstract
In an endeavour to improve the quality of optometric eye care services in South Africa, the scope of practice was expanded to include the use of ocular diagnostic procedures such as goniosco- py that require the use of ophthalmic drugs. The purpose of this study was to assess the practices of specific diagnostic techniques (contact tonometry, 78 D/90 D lens fundus examination, binocular indirect ophthalmoscopy and gonioscopy) requiring the use of ophthalmic drugs among optometrists in KwaZulu-Natal (KZN) province. These specific techniques are referred to as diagnostic procedures in this article. A questionnaire containing information on demography and practice of these specific techniques was sent to all 213 KwaZulu-Natal registered optometrists who owned private practices. One hundred and thirty two completed questionnaires were received, a response rate of 62%. One hundred and seventeen (55%) of the questionnaires were included in the analysis of which 55% of the respondents were females and 45% were males. Sixty two optometrists (53%) were certified in di- agnostic procedures but many procedures were not being practiced. These procedures and the percentage respondents were: Contact tonometry (60%), 78 D/90 D lens fundus examination (60%), binocular indirect ophthalmoscopy (84%) and gonioscopy (78%). Also, among these certified respondents (62 optometrists), a significant proportion (60%) disagreed when asked if they were confident and proficient in performing the relevant diagnostic procedures. Many, (61%) agreed that lack of incentives discouraged them from routinely performing the procedures. More than half (58%), agreed that chair time was an important factor in deciding whether or not to perform these diagnostic procedures. Of the total respondents (117), 86% agreed that they were confident about the accuracy of their referrals and less than half (45%) disagreed that diagnostic procedures should be the sole responsibility of ophthalmologists. Less than half (48%) agreed that diagnostic procedures should be incorporated into routine eye examinations. This study indicatesthat the performance of these diagnostic procedures was limited despite many optometrists having the necessary educational certification. It is recom- mended that initiatives that can be translated into practical action such as CPD workshops should pay greater attention to the improvement of diagnosticskills and practice. In addition, further education or opportunities emphasizing the importance of per- forming these diagnostic procedures over financialgains and time constraints are warranted.
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