Biomedical Sciences Research Institute, School of Biomedical Sciences, University of Ulster, Coleraine, UK.
Ophthalmic Physiol Opt. 2019 May;39(3):148-161. doi: 10.1111/opo.12612. Epub 2019 Apr 7.
To survey a large number of UK-based optometrists, in a variety of settings, to determine current attitudes relating to the use of cycloplegia and spectacle prescribing in children aged ≤11 years.
One thousand randomly selected members of the College of Optometrists (UK) were invited to complete an electronic questionnaire. The questionnaire was comprised of 42 questions relating to respondent demographics, practitioner use of cycloplegia and attitudes to using cycloplegia to assess childhood refractive error and prescribing spectacles for children aged ≤11 years.
Three hundred and eleven practitioners (31%) completed the questionnaire. Practitioners agreed that they are confident carrying out cycloplegic refraction (60%) and instilling cyclopentolate (77%); are not concerned about the time the procedure takes (69%); feel parents are receptive to its use (65%) and are not discouraged by side effects (72%). Most practitioners agreed that they would carry out a cycloplegic refraction in pre-school children (aged 2-4 years) at their first eye exam (34% vs 27%), but would not carry out a cycloplegic refraction in a child of school age (5-7 years: 25% vs 47%, 8-11 years: 12% vs 45%). More recently qualified practitioners are more likely to be proactive in using cycloplegia (Mann-Whitney, p = 0.003). Community practitioners prescribed at slightly lower levels of ametropia in non-strabismic children than those working in a hospital setting both in the present study and in comparison to previously published hospital optometry values, particularly for hyperopia at 1 year of age.
This is the first study to report practitioner use of cycloplegia and attitudes to using cycloplegia to assess childhood refractive error and prescribing spectacles for children in a large number of UK-based optometrists practising in a variety of settings. The majority of practitioners responded in a positive manner to the use of cycloplegia and reported patterns of use which adhere closely to available professional guidance. However, outcomes indicate practitioners may appreciate more comprehensive evidence-based resources to inform their decision-making relating to use of cycloplegia in paediatric examination.
调查英国各地的大量验光师，了解他们在各种环境下对 11 岁以下儿童使用睫状肌麻痹剂和配镜的态度。
随机邀请 1000 名英国验光师协会（CO）成员完成电子问卷调查。问卷包括 42 个问题，涉及受访者人口统计学特征、从业者使用睫状肌麻痹剂的情况以及使用睫状肌麻痹剂评估儿童屈光不正和为 11 岁以下儿童配镜的态度。
311 名从业者（31%）完成了问卷。从业者认为他们对进行睫状肌麻痹验光（60%）和滴用环戊通（77%）有信心；不担心该操作的时间（69%）；认为家长乐于接受该操作（65%），也不会因副作用（72%）而气馁。大多数从业者同意他们会在首次眼部检查时对 2-4 岁的学龄前儿童进行睫状肌麻痹验光（34%比 27%），但不会对 5-7 岁（25%比 47%）和 8-11 岁（12%比 45%）的学龄儿童进行睫状肌麻痹验光。刚获得资格的从业者更倾向于积极使用睫状肌麻痹剂（Mann-Whitney，p=0.003）。社区从业者在非斜视儿童的配镜处方上的离焦程度略低于医院从业者，本研究和之前的医院验光值均如此，尤其是在 1 岁时的远视。
这是第一项报告英国各地大量验光师在各种环境下使用睫状肌麻痹剂和态度的研究，评估儿童屈光不正并为儿童配镜。大多数从业者对使用睫状肌麻痹剂的态度积极，并报告了与现有专业指南密切相关的使用模式。然而，研究结果表明，从业者可能更需要全面的基于证据的资源，以帮助他们在儿科检查中使用睫状肌麻痹剂的决策。
