title: An evidence-based analysis of Australian optometrists' dry eye practices.
abstract: OBJECTIVE
  The aims of this study were to investigate the clinical practices of Australian optometrists as related to the diagnosis, quantification, and management of dry eye and to assess whether these are consistent with research evidence and current guidelines.
  
  
  METHODS
  An online survey was distributed to registered optometrists (n = 654). Respondents provided information regarding their preferred diagnostic procedures and management strategies for dry eye, practice modality, year of commencing practice, and whether they possessed an interest in dry eye.
  
  
  RESULTS
  Respondents (n = 144) used multiple procedures for diagnosis. Recording patient symptoms ranked as the most important, most valuable, and most commonly used technique. The main objective tests were fluorescein-assisted tear breakup time, corneal fluorescein staining, and meibomian gland evaluation. Optometrists with an interest in dry eye more frequently used lissamine green, phenol red test, interference fringes, and tear osmolarity than nonspecialist practitioners. Dry eye treatment varied with severity. The mainstay of therapy was nonpreserved lubricants and eyelid hygiene; more practitioners recommended topical corticosteroids, systemic omega-3 fatty acid supplementation and increased dietary intake of omega-3 fatty acids for moderate and severe disease, respectively. The primary sources of information used to guide practitioners' management were derived from continuing education conferences.
  
  
  CONCLUSIONS
  This study indicates that although Australian optometrists use subjective and objective diagnostic tests and stratify treatment based on dry eye severity, there is a lack of uniformity regarding diagnostic testing, infrequent use of standardized grading scales, and significant variability in clinical care. These findings highlight the potential to improve the translation of dry eye research evidence and evidence-based guidelines into Australian optometric practice.
authors.affiliation: *BOptom, PhD, FAAO †BAppSc(Optom), PhD ‡BScOptom, PhD, FAAO The Department of Optometry and Vision Sciences, University of Melbourne, Melbourne, Victoria, Australia (LED, PRK, AJV); and Macular Research Unit, Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia (PRK).
authors.forename: Laura E
authors.initials: LE
authors.lastname: Downie
authors.forename: Peter R
authors.initials: PR
authors.lastname: Keller
authors.forename: Algis J
authors.initials: AJ
authors.lastname: Vingrys
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D003941:Diagnostic Techniques, Ophthalmological; D015352:Dry Eye Syndromes / Q000175:diagnosis* / Q000628:therapy*; D019317:Evidence-Based Medicine; D019793:Fluorescein / Q000627:therapeutic use; D006306:Health Surveys; D006801:Humans; D008537:Meibomian Glands / Q000502:physiology; D009907:Optometry / Q000706:statistics & numerical data*; D009994:Osmolar Concentration; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013666:Tears / Q000737:chemistry
chemical_list: D019793:Fluorescein