Xue Ally L, Downie Laura E, Ormonde Susan E, Craig Jennifer P
Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand.
Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Australia.
Ophthalmic Physiol Opt. 2017 Mar;37(2):191-201. doi: 10.1111/opo.12349.
The aim of this cross-sectional survey was to evaluate the self-reported clinical practices of New Zealand optometrists and ophthalmologists with respect to the diagnosis and management of dry eye disease. It also sought to compare these behaviours with the current research evidence base.
An anonymous survey was distributed electronically to New Zealand eye care clinicians (optometrists n = 614, ophthalmologists n = 113) to determine practitioner interest in dry eye disease, practice experience, practice modality, preferred diagnostic and management strategies, and information used to guide patient care.
Respondents from both professions (response rates, optometrists: 26%, ophthalmologists: 26%) demonstrated similarly strong knowledge of tear film assessment. Ninety percent of respondents ranked patient symptoms and meibomian gland evaluation as the most valuable and common diagnostic approaches. Conversely, standardised grading scales and validated dry eye questionnaires were infrequently adopted. Both professions tailored dry eye management according to severity, indicating eyelid hygiene and non-preserved lubricants as mainstay therapies. Ophthalmologists prescribed systemic tetracyclines significantly more often than optometrists for moderate (48% vs 11%) and severe (72% vs 32%) dry eye (p < 0.05). Continuing education conferences were acknowledged as the primary information source used to guide dry eye management practices by both professions.
Consistent with evidence-based guidelines, New Zealand eye care professionals combine subjective and objective techniques to diagnose and stratify dry eye management according to disease severity. There is potential to improve dissemination of research evidence into clinical practice, with continuing education via professional conferences the favoured mode of delivery.
这项横断面调查旨在评估新西兰验光师和眼科医生在干眼症诊断和管理方面自我报告的临床实践。它还试图将这些行为与当前的研究证据基础进行比较。
通过电子方式向新西兰眼科护理临床医生（验光师n = 614，眼科医生n = 113）分发了一份匿名调查问卷，以确定从业者对干眼症的兴趣、实践经验、实践方式、首选的诊断和管理策略以及用于指导患者护理的信息。
两个专业的受访者（回复率，验光师：26%，眼科医生：26%）对泪膜评估表现出同样扎实的知识。90%的受访者将患者症状和睑板腺评估列为最有价值和最常用的诊断方法。相反，标准化分级量表和经过验证的干眼问卷很少被采用。两个专业都根据严重程度调整干眼症管理方案，表明眼睑卫生和无防腐剂润滑剂是主要治疗方法。对于中度（48%对11%）和重度（72%对32%）干眼症，眼科医生开具全身性四环素的频率明显高于验光师（p < 0.05）。继续教育会议被两个专业公认为用于指导干眼症管理实践的主要信息来源。
与循证指南一致，新西兰眼科护理专业人员结合主观和客观技术，根据疾病严重程度对干眼症进行诊断和分层管理。通过专业会议进行继续教育是首选的传播方式，将研究证据传播到临床实践中仍有改进空间。
