Management of diabetic retinopathy by Australian optometrists. Working Group on Evaluation of NHMRC Retinopathy Guideline Distribution. National Health and Medical Research Council.
OBJECTIVE
To describe current practices related to the management of diabetic retinopathy by Australian optometrists.


METHODS
A two-page self-administered questionnaire was mailed to a random sample of 504 Australian optometrists. The survey included questions about the practice (such as size and location); current practice with regard to management of patients with diabetic retinopathy; barriers to use of dilating drops; and a number of patient scenarios related to screening, follow-up and treatment of diabetic retinopathy.


RESULTS
Completed questionnaires were returned by 407 of the 473 eligible optometrists (86%). They had been practising optometry between 1 and 50 years (median 14). Of the 243 optometrists who provided details about the location of their practices, 145 (37%) had at least one of their practices in a rural area. The estimated percentage of patients with diagnosed diabetes ranged from 0.5 to 40% (median = 5.0%). Three-hundred and twenty-two optometrists (79%) reported that they would often or almost always ask new patients over the age of 40 whether they have diabetes. The majority of optometrists (n = 387, 95%) would often or almost always ask their new patients with diabetes about their control of blood glucose levels and the majority of optometrists (n = 330, 81%) would often or almost always tell their patients with diabetes about the importance of strict glucose control in delaying retinopathy. The most common barrier to dilated ophthalmoscopy was patients not wanting to be dilated, with 38.1% of optometrists reporting this to be a moderate or major barrier. The next most common barrier was fear of precipitating angle closure glaucoma; 17.1% of optometrists reported this to be a moderate or major barrier


CONCLUSIONS
The National Health and Medical Research Council (NHMRC) guidelines for the management of diabetic retinopathy are timely in relation to the expressed desire of Australian optometrists to learn more about management of diabetic retinopathy These data will be used prospectively to assess changes in management of patients with diabetic retinopathy as a result of the release of the NHMRC guidelines.
McCarty
C A
CA
Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia. cathy@iris.medoph.unimelb.edu.au
McKay
R
R
Keeffe
J E
JE
D001315:Australia; D002648:Child; D003930:Diabetic Retinopathy / Q000175:diagnosis* / Q000628:therapy*; D003941:Diagnostic Techniques, Ophthalmological; D006302:Health Services Research; D006801:Humans; D008875:Middle Aged; D009907:Optometry / Q000379:methods*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011897:Random Allocation; D011795:Surveys and Questionnaires