Ocular foreign bodies: evolution of professional roles and public costs in Quebec

Purpose In 2003, Quebec optometrists were legally enabled to extract superficial ocular foreign bodies, with part of this service covered by the universal health insurance. This study analyses the evolution of roles for professionals managing this condition (optometrists, ophthalmologists, emergency physicians and family physicians) and the related public healthcare costs. Methods Data from the provincial health insurance were combined to demographic and annual healthcare workforce statistics. Across professions and sociosanitary regions, variations in annual rates of conditions treated were calculated, as well as variations in public healthcare costs. Linear regression slopes of these variations were used as indicators of linear trends. Results Between 2010 and 2016, the proportion of cases managed by optometrists increases from 32% to 44%, following a significant trend (p < 0.007). For family physicians, the proportion of cases managed decreases from 49% to 33%, following a significant trend (p < 0.0001). The increase in optometrists managing cases is visible in almost all sociosanitary regions, reaching +19%. A significant trend was observed for increasing healthcare costs for optometrists (p < 0.008) and ophthalmologists (p < 0.004) and for decreasing healthcare costs for family physicians (p < 0.001). In 2016, optometrists managed 44% of cases, representing 13% of related healthcare costs. Conclusion In Quebec, optometrists are now the professionals managing the largest proportion of superficial ocular foreign bodies, across the province. There is an apparent shift from the proportion of cases managed by family physicians, which have similarly decreased

Corps étrangers oculaires : évolution des rôles professionnels et des coûts pour le régime de santé public du Québec

En 2003, les optométristes du Québec ont été autorisés en vertu de la loi à extraire des corps étrangers oculaires superficiels, une partie de ce service étant couverte par le régime universel d’assurance-maladie. Cette étude anal-yse l’évolution du rôle des professionnels qui prennent en charge ce prob-lème (optométristes, ophtalmologistes, urgentologues et omnipraticiens) et les coûts connexes des soins de santé publics

Priorities in school eye health in low and middle-income countries a scoping review.

School eye health (SEH) has been on the global agenda for many years, and there is mounting evidence available to support that school-based visual screenings are one of the most effective and cost-efficient interventions to reach children over five years old. A scoping review was conducted in MEDLINE, Web of Science, PubMed, and CINHAL between February and June 2023 to identify current priorities in recent literature on school eye health in low- and middle-income countries (LMICs). Selection of relevant publications was performed with Covidence, and the main findings were classified according to the WHO Health Promoting Schools framework (HPS). A total of 95 articles were included: cross-sectional studies (n = 55), randomised controlled trials (n = 7), qualitative research (n = 7) and others. Results demonstrate that multi-level action is required to implement sustainable and integrated school eye health programmes in low and middle-income countries. The main priorities identified in this review are: standardised and rigorous protocols; cost-effective workforce; provision of suitable spectacles; compliance to spectacle wear; efficient health promotion interventions; parents and community engagement; integration of programmes in school health; inter-sectoral, government-owned programmes with long-term financing schemes. Even though many challenges remain, the continuous production of quality data such as the ones presented in this review will help governments and other stakeholders to build evidence-based, comprehensive, integrated, and context-adapted programmes and deliver quality eye care services to children all over the world

Optometric Care of the Patient with Diabetes

The Canadian Association of Optometrists (CAO) is the national voice of optometry and is dedicated to collaboratively advancing the highest standard of primary eye care through the promotion of optimal vision and eye health, in partnership with all Canadians. Optometrists are the front line of eye health and vision care. They are experts in primary eye care and are well-positioned to help combat the vision related complications of diabetes. CAO assembled the Diabetes Guidelines Working Group to create national guidelines on the clinical management of diabetes mellitus in an effort to further educate Canadian optometrists and assist them in the management of this chronic disease. The Working Group consists of optometrists from private practice, research and academia, chosen on the basis of their expertise, experience and representation from across Canada

Co-organisation of CongoResearchNetwork PhD Days (May 28-29 2019, at Vrije Universiteit Brussel)

first PhD Days organized by the CongoResearchNetworkstatus: publishe

How should New Zealand implement the "Eye Health Check" for older adults to maximise the potential to reduce vision impairment? Protocol for a Rapid Review

The aim of this rapid review is to draw on evidence from other countries to inform New Zealand’s eye care policies for older adults. Specifically, this protocol describes the methods that will be used to scope: 1) the primary eye care services available for older adults in a selection of high-income, English speaking countries, and 2) the evidence that these programmes reduce visual impairment or provide universal health coverage within the WHO’s recommendation

Primary eye health services for older adults as a component of universal health coverage: A scoping review of evidence from high income countries

UNLABELLED: In pursuit of Universal Health Coverage (UHC) for eye health, countries must strengthen services for older adults, who experience the highest prevalence of eye conditions. This scoping review narratively summarised (i) primary eye health services for older adults in eleven high-income countries/territories (from government websites), and (ii) the evidence that eye health services reduced vision impairment and/or provided UHC (access, quality, equity, or financial protection) (from a systematic literature search). We identified 76 services, commonly comprehensive eye examinations ± refractive error correction. Of 102 included publications reporting UHC outcomes, there was no evidence to support vision screening in the absence of follow-up care. Included studies tended to report the UHC dimensions of access (n=70), equity (n=47), and/or quality (n=39), and rarely reported financial protection (n=5). Insufficient access for population subgroups was common; several examples of horizontal and vertical integration of eye health services within the health system were described. FUNDING: This work was funded by Blind Low Vision New Zealand for Eye Health Aotearoa

Grand Challenges in global eye health: a global prioritisation process using Delphi method

Background: We undertook a Grand Challenges in Global Eye Health prioritisation exercise to identify the key issues that must be addressed to improve eye health in the context of an ageing population, to eliminate persistent inequities in health-care access, and to mitigate widespread resource limitations. Methods: Drawing on methods used in previous Grand Challenges studies, we used a multi-step recruitment strategy to assemble a diverse panel of individuals from a range of disciplines relevant to global eye health from all regions globally to participate in a three-round, online, Delphi-like, prioritisation process to nominate and rank challenges in global eye health. Through this process, we developed both global and regional priority lists. Findings: Between Sept 1 and Dec 12, 2019, 470 individuals complete round 1 of the process, of whom 336 completed all three rounds (round 2 between Feb 26 and March 18, 2020, and round 3 between April 2 and April 25, 2020) 156 (46%) of 336 were women, 180 (54%) were men. The proportion of participants who worked in each region ranged from 104 (31%) in sub-Saharan Africa to 21 (6%) in central Europe, eastern Europe, and in central Asia. Of 85 unique challenges identified after round 1, 16 challenges were prioritised at the global level; six focused on detection and treatment of conditions (cataract, refractive error, glaucoma, diabetic retinopathy, services for children and screening for early detection), two focused on addressing shortages in human resource capacity, five on other health service and policy factors (including strengthening policies, integration, health information systems, and budget allocation), and three on improving access to care and promoting equity. Interpretation: This list of Grand Challenges serves as a starting point for immediate action by funders to guide investment in research and innovation in eye health. It challenges researchers, clinicians, and policy makers to build collaborations to address specific challenges. Funding: The Queen Elizabeth Diamond Jubilee Trust, Moorfields Eye Charity, National Institute for Health Research Moorfields Biomedical Research Centre, Wellcome Trust, Sightsavers, The Fred Hollows Foundation, The Seva Foundation, British Council for the Prevention of Blindness, and Christian Blind Mission. Translations: For the French, Spanish, Chinese, Portuguese, Arabic and Persian translations of the abstract see Supplementary Materials section.</p