Sharma Nikhil, Martin Eilidh, Pearce Edward Ian, Hagan Suzanne, Purslow Christine, Craig Jennifer P
Glasgow Caledonian University, Glasgow, Scotland, UK.
Christine Purslow - School of Optometry and Vision Sciences, Cardiff University, Cardiff, Wales, UK.
Clin Optom (Auckl). 2024 Sep 28;16:255-265. doi: 10.2147/OPTO.S469599. eCollection 2024.
The primary aim of this study was to compare how eyecare professionals in disparate regions of the world diagnose and manage Demodex blepharitis. A secondary aim was to explore interprofessional differences in diagnostic and management practices.
Ophthalmologists and optometrists from India and Australia/New Zealand, were invited to complete an online survey on Demodex blepharitis. Clinical practice patterns relating to patients with Demodex blepharitis, with details of how they investigate and manage Demodex blepharitis in clinical practice, were collected along with clinician demographics and general perceptions on eyelid health. Mann-Whitney U, and Fisher's exact tests were used for statistical analysis.
A total of 261 eyecare professionals completed the survey, comprising 207 from India (84% optometrists) and 54 from Australia and New Zealand (91% optometrists). Almost 70% of practitioners across the 3 countries recognized Demodex blepharitis as a cause of ocular discomfort, yet only 45% reported attempting to identify Demodex in their patients. There were significant differences noted in clinical practice between those in Australasia and India. Perceived prevalence of Demodex blepharitis also differed (60% in Australasia vs 27% in India; p<0.01), as well as, the choice of slit lamp magnification used to detect the mites (25x in Australasia vs 16x in India; p = 0.02), preferred treatment option to manage Demodex blepharitis (tea tree oil in Australasia vs Standard lid hygiene in India; p = 0.01), treatment duration (from 3-4 weeks to over 12 weeks in Australasia vs 3-4 weeks in India; p = 0.02) and treatment application frequency (once daily in Australasia vs twice daily in India; p = 0.01).
This study highlights differences in clinical evaluation and treatment practices between eyecare professionals in India and Australasia. Overall, practitioners in Australia and New Zealand were more evidence-based in their investigation and management. However, in both regions, interprofessional differences in perceived optimal treatment duration and frequency were reported.
本研究的主要目的是比较世界不同地区的眼保健专业人员对蠕形螨睑缘炎的诊断和管理方式。次要目的是探讨诊断和管理实践中的跨专业差异。
邀请来自印度以及澳大利亚/新西兰的眼科医生和验光师完成一项关于蠕形螨睑缘炎的在线调查。收集了与蠕形螨睑缘炎患者相关的临床实践模式，以及他们在临床实践中对蠕形螨睑缘炎进行检查和管理的详细情况，同时收集了临床医生的人口统计学信息和对眼睑健康的总体看法。采用曼-惠特尼U检验和费舍尔精确检验进行统计分析。
共有261名眼保健专业人员完成了调查，其中207名来自印度（84%为验光师），54名来自澳大利亚和新西兰（91%为验光师）。这三个国家中近70%的从业者认为蠕形螨睑缘炎是眼部不适的一个原因，但只有45%的人报告曾尝试在患者中识别蠕形螨。在大洋洲和印度的临床实践中存在显著差异。蠕形螨睑缘炎的感知患病率也有所不同（大洋洲为60%，印度为27%；p<0.01），用于检测螨虫的裂隙灯放大倍数的选择也不同（大洋洲为25倍，印度为16倍；p = 0.02），管理蠕形螨睑缘炎的首选治疗方案不同（大洋洲为茶树油，印度为标准睑缘清洁；p = 0.01），治疗持续时间不同（大洋洲为3至4周以上至超过12周，印度为3至4周；p = 0.02）以及治疗应用频率不同（大洋洲为每日一次，印度为每日两次；p = 0.01）。
本研究突出了印度和大洋洲眼保健专业人员在临床评估和治疗实践方面的差异。总体而言，澳大利亚和新西兰的从业者在其检查和管理中更具循证性。然而，在这两个地区，都报告了在感知的最佳治疗持续时间和频率方面的跨专业差异。
