School of Optometry, The University of Alabama at Birmingham, Birmingham, Alabama.
Optom Vis Sci. 2020 Mar;97(3):137-144. doi: 10.1097/OPX.0000000000001487.
There is a dearth of studies investigating the challenges encountered in dry eye practice. Profiling these barriers is crucial to improving dry eye diagnosis and patient care.
This study aimed to examine the diagnostic and treatment perspectives, and challenges in dry eye practice in Ghana.
An anonymous paper-based or web survey regarding dry eye practice pattern, practice challenges, and access to diagnostic tools was distributed to 280 potential participants.
One hundred thirteen respondents completed the survey. Case history (92.5%), fluorescein tear breakup time (87.5%), and corneal fluorescein staining (72.5%) were the topmost procedures used for dry eye diagnosis. A preserved lubricant drop was the most commonly prescribed treatment of mild, moderate, and severe dry eye at the rates of 77.0, 83.2, and 77.0%, respectively. A few respondents prescribed cyclosporine (2.7%) or punctal plugs (5.3%) across all disease severities, and none used scleral lens, autologous serum tears, or thermal pulsation. Graduate professional training influenced the practice pattern of 82.3% of respondents, whereas continuing professional education influenced less than 1%. Approximately 70.1 and 92.8% of optometrists considered referring dry eye in children and cases that are unresponsive to treatment, respectively. Eighty-eight percent of practitioners indicated they experience a challenge in dry eye practice, with limited access to diagnostic tools (77.9%) and limited availability of effective dry eye medication on the Ghanaian market (50.4%) being the most frequent challenges. More than 85% of respondents had access to a fluorescein dye or slit-lamp biomicroscope; however, none had access to a phenol red thread, lissamine green dye, osmolarity technology, or meibography device.
Practitioners' limited access to diagnostic tools/techniques and the limited effective dry eye treatments are major challenges encountered in dry eye practice in Ghana. Addressing these will improve dry eye practice and treatment outcomes in the country.
目前，研究干眼症实践中遇到的挑战的相关文献很少。对这些障碍进行分析对提高干眼症的诊断和患者护理水平至关重要。
本研究旨在探讨加纳干眼症实践中的诊断和治疗观点及挑战。
以干眼症的诊疗模式、实践挑战和诊断工具的可及性为主题，向 280 名潜在参与者发放了匿名纸质或网络调查问卷。
共有 113 名受访者完成了调查。病史（92.5%）、泪膜破裂时间（87.5%）和角膜荧光素染色（72.5%）是干眼症诊断中最常用的程序。在轻度、中度和重度干眼症中，最常开的治疗药物是保存型润滑剂，使用率分别为 77.0%、83.2%和 77.0%。少数受访者在所有疾病严重程度下使用环孢素（2.7%）或泪点塞（5.3%），但没有使用巩膜镜、自体血清泪液或热脉冲治疗。研究生专业培训影响了 82.3%受访者的实践模式，而继续教育的影响不到 1%。约 70.1%和 92.8%的视光师分别考虑转诊儿童干眼症和治疗无反应的干眼症病例。88%的从业者表示他们在干眼症的诊疗中遇到了挑战，其中诊断工具的有限获取（77.9%）和加纳市场上有效干眼症药物的有限供应（50.4%）是最常见的挑战。超过 85%的受访者可以获得荧光素染料或裂隙灯生物显微镜；然而，没有人可以获得苯酚红线、丽丝胺绿染料、渗透压技术或睑板腺成像设备。
在加纳，干眼症诊疗中主要面临从业者获取诊断工具/技术的机会有限和有效的干眼症治疗方法有限等挑战。解决这些问题将改善该国干眼症的诊疗水平和治疗效果。
