title: How optometrists record corneal staining.
abstract: OBJECTIVE
  The aim of this study was to determine current approaches adopted by optometrists to the recording of corneal staining following fluorescein instillation.
  
  
  METHODS
  An anonymous 'record-keeping task' was sent to all 756 practitioners who are members of the Queensland Division of Optometrists Association Australia. This task comprised a form on which appeared a colour photograph depicting contact lens solution-induced corneal staining. Next to the photograph was an empty box, in which practitioners were asked to record their observations. Practitioners were also asked to indicate the level of severity of the condition at which treatment would be instigated.
  
  
  RESULTS
  Completed task forms were returned by 228 optometrists, representing a 30 per cent response rate. Ninety-two per cent of respondents offered a diagnosis. The most commonly used descriptive terms were 'superficial punctate keratitis' (36 per cent of respondents) and 'punctate staining' (29 per cent). The level of severity and location of corneal staining were noted by 69 and 68 per cent of respondents, respectively. A numerical grade was assigned by 44 per cent of respondents. Only three per cent nominated the grading scale used. The standard deviation of assigned grades was ± 0.6. The condition was sketched by 35 per cent of respondents and two per cent stated that they would take a photograph of the eye. Ten per cent noted the eye in which the condition was being observed. Opinions of the level of severity at which treatment for corneal staining should be instigated varied considerably between practitioners, ranging from 'any sign of corneal staining' to 'grade 4 staining'.
  
  
  CONCLUSIONS
  Although most practitioners made a sensible note of the condition and properly recorded the location of corneal staining, serious deficiencies were evident regarding other aspects of record-keeping. Ongoing programs of professional optometric education should reinforce good practice in relation to clinical record-keeping.
authors.affiliation: Institute of Health and Biomedical Innovation and School of Optometry, Queensland University of Technology, Brisbane, Queensland, Australia. n.efron@qut.edu.au
authors.forename: Nathan
authors.initials: N
authors.lastname: Efron
authors.forename: Nicola
authors.initials: N
authors.lastname: Pritchard
authors.forename: Kady
authors.initials: K
authors.lastname: Brandon
authors.forename: Joanne
authors.initials: J
authors.lastname: Copeland
authors.forename: Roslyn
authors.initials: R
authors.lastname: Godfrey
authors.forename: Benjamin
authors.initials: B
authors.lastname: Hamlyn
authors.forename: Vanessa
authors.initials: V
authors.lastname: Vrbancic
mesh_terms: D001315:Australia; D018639:Contact Lens Solutions / Q000009:adverse effects; D003315:Cornea / Q000187:drug effects / Q000473:pathology*; D019793:Fluorescein; D005456:Fluorescent Dyes; D006801:Humans; D007634:Keratitis / Q000139:chemically induced / Q000473:pathology; D009907:Optometry / Q000379:methods*; D011996:Records / Q000592:standards*; D012720:Severity of Illness Index; D013194:Staining and Labeling
chemical_list: D018639:Contact Lens Solutions; D005456:Fluorescent Dyes; D019793:Fluorescein