Thesis (MPH.) --University of Limpopo, 2010 / The Department of health, Limpopo province in recent years has developed eye care services in public hospitals. It is reckoned that people living in the rural areas would benefit significantly from the cheaper public eye care services. However, the level of utilization of the public eye care services by the rural communities in the province has not been investigated. It was therefore, considered of interest to evaluate whether or not the services are being utilized adequately or not. AIM OF THE STUDY The aim of this study was to investigate whether or not the public eye care services in the Capricorn district, Limpopo Province are adequately utilized by the rural population. METHODOLOGY A cross-sectional qualitative survey study design was used. A questionnaire with 42 questions on the utilization of eye care services was developed in English, translated to Northern Sotho (the local dialect) and back translated to ensure veracity. The questionnaire included questions on demography, knowledge of available eye care services, need for eye care services, utilization, attitude and perception of public eye care services. The questionnaire was field-tested in a pilot study conducted prior to the study and involves 20 participants, with final amendments made to ensure clarity of contents. The participants included males and females from 1000 households in selected 38 villages. The questionnaire was delivered to the head of each household for completion. Data analysis was done with computer software SPSS (Statistical Package for Social Sciences) version 15. Results are presented in narrative and tabular forms and as figures.

Yes / Purpose There is a high level of over-referral from primary eye care leading to significant numbers of people without ocular pathology (false positives) being referred to secondary eye care. The present study used a psychometric instrument to determine whether there is a psychological burden on patients due to referral to secondary eye care, and used Rasch analysis to convert the data from an ordinal to an interval scale. Design Cross sectional study. Participants and Controls 322 participants and 80 control participants. Methods State (i.e. current) and trait (i.e. propensity to) anxiety were measured in a group of patients referred to a hospital eye department in the UK and in a control group who have had a sight test but were not referred. Response category analysis plus infit and outfit Rasch statistics and person separation indices were used to determine the usefulness of individual items and the response categories. Principal components analysis was used to determine dimensionality. Main Outcome Measure Levels of state and trait anxiety measured using the State-Trait Anxiety Inventory. Results State anxiety scores were significantly higher in the patients referred to secondary eye care than the controls (p<0.04), but similar for trait anxiety (p>0.1). Rasch analysis highlighted that the questionnaire results needed to be split into “anxiety-absent” and “anxiety-present” items for both state and trait anxiety, but both subscales showed the same profile of results between patients and controls. Conclusions State anxiety was shown to be higher in patients referred to secondary eye care than the controls, and at similar levels to people with moderate to high perceived susceptibility to breast cancer. This suggests that referral from primary to secondary eye care can result in a significant psychological burden on some patients. / University of Bradford

published_or_final_version / Nursing Studies / Master / Master of Nursing

Yes

Accessible and affordable eye care is only a dream for much of the population of developing countries. Strategies for improving the visual welfare of these people need to be appropriate to the local situation. In 1992 a proposal was devised to address the lack of eye care in Papua New Guinea. This thesis examines the outcome of this proposal and reports on the ophthalmic data collected by these trained eye nurses.Method: In 1994, 11 National nurses were trained in a 3 month intensive course to become ‘eye nurses’. A basic set of equipment was provided to each eye nurse. Appropriate follow-up and annual conferences supported this initial training. A second group of 14 eye nurses were trained in 1997. Monthly eye clinic reports from the eye nurses provide significant data on eye conditions and visual welfare in PNGResults: After 6 years 80% of the eye nurses were still actively working in eye care. An analysis was made of the eye conditions of the 30,000 patients examined by the eye nurses over this 6 year period. The data is generally consistent with previous ophthalmic data from Papua New Guinea. The eye nurses were able to provide appropriate eye care for 80% of the presenting patients without Optometric or Ophthalmic assistance.Conclusions: Training nurses to become ‘eye nurses’ functioning as basic optometrists is an effective strategy in improving eye care in developing countries. The eye nurses were able to deliver sustainable, accessible, affordable and appropriate eye care, independently treating and managing the most common eye conditions in Papua New Guinea.

The problem of this research was to make a survey of cumulative and permanent records of the children in the Ascher Silberstein Elementary School in order to discover the eye conditions, and to determine the necessity for an expanded program of eye hygiene.

As at 2014, 19 million children aged < 16 years were visually impaired, 1.4 million of these children were blind and needed visual rehabilitation interventions. Surveys, mostly utilizing key informants (KI), have suggested that the prevalence of blindness in children in Sub Saharan Africa ranges between 2 -8 per 10,000 children. Childhood eye disease is rare and conditions are difficult to detect; thus, surveys to estimate the prevalence of blindness requires rigorous, costly and difficult methods to obtain reasonable estimates among children. Key informant programs, which engage the community in case finding, have been shown to be a reasonable alternative to large scale surveys and were used in Madagascar in 2014 by four regional eye care programmes. I propose to analyse the data generated from the programmes to quantify the prevalence of eye conditions among children and how the KIs performed. Method: The analysis will use data collected in a cross sectional approach. Statistical analysis will be conducted using Stata (15.0) statistical software. Data from all of the KI registers will be pooled and overall magnitude estimates calculated. KI productivity and sub-group analyses will include assessment of demographic characteristics of the children and the KI by age and sex. Ethical approval will be provided by the UCT Health Research and Ethics Committee and the Madagascar Ministry of Health. Discussion: The results from this study will help child eye health programmes to determine how best to use KI to better serve children with vision loss, and guide in the provision of eye services for children care.

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.

Yes / The model for delivery of primary eye care in Europe varies from country to country with differing reliance on ophthalmologists, optometrists and dispensing opticians. Comparative analysis of models has tended to focus on interprofessional working arrangements, training and regulatory issues, rather than on whether a particular model is effective for delivering public health goals for that country. National Health Service (NHS) primary eye care services in the UK are predominantly provided under a General Ophthalmic Services (GOS) Contract between the NHS and practice owners (Contractors). Over two-thirds of sight tests conducted in England, Wales and Northern Ireland and all in Scotland are performed under a GOS Contract, however many people entitled to a GOS sight test do not take up their entitlement. The fee paid for sight tests conducted under a GOS Contract in England, Wales and Northern Ireland does not cover the full cost of conducting the examination. The shortfall must be made up through profits of sale of optical appliances but this business model can be a deterrent to establishing practices within socioeconomically deprived communities, and can also be a barrier to uptake of sight tests, even though many people are entitled to a NHS optical voucher towards the cost of spectacles or contact lenses. This paper critiques the GOS Contracts within the UK. We argue that aspects of the way the GOS Contract is implemented are contrary to the public health interest and that different approaches are needed to address eye health inequalities and to reduce preventable sight loss.

No / From the publisher - Well organized and easy to read, Clinical Procedures in Primary Eye Care, 5th Edition, takes an accessible, step-by-step approach to describing the commonly used primary care procedures that facilitate accurate diagnosis and effective patient management. This practical, clinically-focused text offers succinct descriptions of today's most frequently encountered optometric techniques supported by research-based evidence. You’ll find essential instructions for mastering the procedures you need to know, including recent technical advances in the field.