Sosuan George Michael N, Sandoval Pablito F, Torrefranca Aramis B, Tan Reginald Robert G, Lim Bon Siong Ruben
Department of Ophthalmology and Visual Sciences, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.
Eye Institute, St. Luke's Medical Center, Quezon City, Philippines.
Clin Ophthalmol. 2023 Jan 21;17:303-312. doi: 10.2147/OPTH.S399665. eCollection 2023.
This study aimed to determine the knowledge, attitude, and practices of non-ophthalmic physicians-in-training regarding recognition and prevention of exposure keratopathy among patients admitted in a tertiary referral hospital.
This study was a single-center cross-sectional study. An anonymous self-administered online questionnaire was distributed among non-ophthalmic physicians-in-training at the Philippine General Hospital (PGH) using convenience and snowball sampling.
A total of 77 responses were recorded with a response rate of 37%. The majority of the respondents uniformly reported the absence of an established eye care protocol or policy being implemented for different subsets of patients at risk for developing exposure keratopathy. Ninety-six percent (96%) was aware of exposure keratopathy. The most urgent reason for referral to the ophthalmology service was the presence of whitish of opacity at 46.8%, while the least urgent reason was the presence of eye redness at 36.4%. Only 43% of the patients with incomplete eyelid closure was referred to the ophthalmology service. The most frequently used modality of prophylactic eye protection treatment was eyelid taping (84.4%) followed by lubricants (drops and gels, 79.1%). The most common reason for not referring was the absence of an established protocol on the appropriate indication for referral to the ophthalmology service.
This study showed that the majority of non-ophthalmic physicians-in-training had adequate knowledge and favorable attitude regarding recognition and prevention of exposure keratopathy among patient admitted at the PGH; however, the absence or the unavailability of an eye care protocol among patients with inadequate eyelid closure in our institution on the prevention of exposure keratopathy and its early treatment and appropriate indications for ophthalmology referral resulted in non-uniformity and varied practice patterns on its management.
本研究旨在确定三级转诊医院中接受培训的非眼科医生在识别和预防暴露性角膜病变方面的知识、态度和实践情况。
本研究为单中心横断面研究。采用方便抽样和滚雪球抽样的方法，向菲律宾总医院（PGH）接受培训的非眼科医生发放匿名的自填式在线问卷。
共记录到77份回复，回复率为37%。大多数受访者一致报告，对于有发生暴露性角膜病变风险的不同患者亚组，未实施既定的眼部护理方案或政策。96%的人知晓暴露性角膜病变。转诊至眼科服务的最紧急原因是出现白色混浊，占46.8%，而最不紧急的原因是眼睛发红，占36.4%。仅有43%眼睑闭合不全的患者被转诊至眼科服务。预防性眼部保护治疗最常用的方式是眼睑粘贴（84.4%），其次是润滑剂（滴眼液和眼凝胶，79.1%）。不转诊的最常见原因是缺乏关于转诊至眼科服务的适当指征的既定方案。
本研究表明，大多数接受培训的非眼科医生在识别和预防PGH住院患者的暴露性角膜病变方面有足够的知识和良好的态度；然而，在我们机构中，眼睑闭合不全患者缺乏预防暴露性角膜病变及其早期治疗的眼部护理方案，以及眼科转诊的适当指征，导致其管理存在不一致性和不同的实践模式。
