Referrals from community optometrists in England and their replies: A mixed methods study.

Purpose: Community optometrists, through routine eye examinations, identify patients with disease or ocular abnormalities requiring referral to the Hospital Eye Service. In many cases no reply to the referral letter is received, resulting in some patients being re-referred unnecessarily, potentially increasing the number of other patients who lose sight whilst on hospital waiting lists. This study investigated, qualitatively and quantitatively, factors influencing optometric referrals and replies.

Design and use of vignettes to investigate referral decision-making by optometrists.

Purpose: This study describes the design and application of a range of online clinical vignettes for measuring the impact of Continuing Education and Training (CET) and identifying unwarranted variation in optometric decision-making concerning referrals to secondary care.

Methods: Twenty computerised vignettes were developed to assess clinical and referral management decisions taken in primary care optometry. The online system was specifically designed to present vignettes (ten pre-CET and ten post-CET) that avoided prompting correct answers.

An evaluation of MRI lumbar spine scans within a community-based diagnostic setting.

Background: With an ongoing move towards more management of patients within the community setting, demand for magnetic resonance imaging (MRI) is increasing and commonly used in lower back conditions. There is well recorded overuse of MRI in this scenario which goes against evidence-based practice and adds to rising healthcare costs.

Methods: The study was a retrospective review of lumbar spine MRI scans performed within a community-based setting over an 18-month period.

Randomised controlled trial of corneal vs. scleral rigid gas permeable contact lenses for keratoconus and other ectatic corneal disorders.

Purpose: To compare the comfort and visual performance of corneal rigid gas permeable contact lenses (CoL) and scleral rigid gas permeable contact lenses (SL) in participants with corneal ectasia, successfully wearing "habitual" CoL.

Methods: In a randomised controlled trial (RCT) with a 2 × 2 crossover, 34 participants were recruited and randomised into two groups. Group 1 (sequence AB), were fitted in period 1, with new CoL and after a 4-week washout period, in which habitual CoL were worn, were fitted with and crossed-over to SL, period 2.

The relationship between unwarranted variation in optometric referrals and time since qualification.

Purpose: To investigate variation in optometric referral decision-making and the influence of experience and continuing education and training (CET).

Methods: To gain insight into unwarranted variation in referral activity in the United Kingdom (UK): (1) triage data were audited to investigate source of referral, provisional diagnosis, and outcome; (2) an online system was developed to present two sets of 10 vignettes, designed to avoid prompting answers. Participating optometrists completed 10 pre-CET vignettes, recording their tests and management decisions.

Sunglass Filter Transmission and Its Operational Effect in Solar Protection for Civilian Pilots.

Introduction: The ocular effects of excess solar radiation exposure are well documented. Recent evidence suggests that ocular ultraviolet radiation (UVR) exposure to professional pilots may fall outside international guideline limits unless eye protection is used. Nonprescription sunglasses should be manufactured to meet either international or national standards.

Occupational Ocular UV Exposure in Civilian Aircrew.

Introduction: Ultraviolet radiation (UVR) increases with altitude; however, there are a number of other factors which may influence ocular exposure during flight. The aim of this study was to assess ocular UVR exposure of pilots in airline and off-shore helicopter operations on different aircraft types and to compare with exposure in a typical office environment.

Method: In-flight data were captured on equipment including a CCD array spectroradiometer on five return sector European airline flights and one transatlantic flight from London Gatwick in addition to four helicopter flights from Aberdeen Dyce airport.

Solar Eye Protection Practices of Civilian Aircrew.

Introduction: There is good evidence that long term exposure to ultraviolet (UV) radiation increases the risk of cataracts. The 'blue light hazard' is considered a risk factor for retinal changes similar to those seen in macular degeneration. Previous studies ascertaining the prevalence of radiation related ocular disease in pilot cohorts have not considered use of solar eye protection.

Knowledge, attitudes, beliefs, behaviour and breast cancer screening practices in Ghana, West Africa.

Background: Late presentation has been observed as the hallmark of breast cancer in Ghanaian women where over 60% of patients report with either stage 3 or 4 of the disease. This cross-sectional study aimed at exploring breast cancer related knowledge and practices in order to develop an appropriate socio-economic and cultural specific model to improve breast cancer care in Ghana.

Methods: The study which was conducted in Accra and Sunyani in Ghana used both quantitative and qualitative methods and employed the theory of planned behavior as a communication and educational model.

Civilian pilot exposure to ultraviolet and blue light and pilot use of sunglasses.

Population and animal studies indicate that long-term exposure to short-wavelength visible light and ultraviolet (UV) radiation causes increased risk of certain ocular pathologies such as cataracts and maculopathy. The potential risk to flight crew is unknown. The UK Civil Aviation Authority (CAA) has issued guidance to pilots regarding sunglass selection; however, it is not known if this guidance is appropriate given pilots' unique occupational environment.