Junior Obinwanne Chukwuemeka, Barrah Sharon, Kobia-Acquah Emmanuel, Titiati Perfect Emefa, Karikari Lucy Akua Afriyie, Akowuah Prince
Cornea and Contact Lens Unit (C.J.O., S.B.), De Lens Ophthalmic Family and Vision Care Centre, Abuja, Nigeria; Department of Optometry and Visual Science (E.K.-A., P.A.), Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; Centre for Eye Research Ireland (E.K.-A.), Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland; Permeff Eye Care (P.E.T.), Accra, Ghana; First Vision Eye Care (L.A.A.K.), Kumasi, Ghana; and College of Optometry (P.A.), University of Houston, Houston, TX.
Eye Contact Lens. 2025 Feb 1;51(2):70-75. doi: 10.1097/ICL.0000000000001139. Epub 2024 Oct 29.
To investigate the referral and management patterns of patients with keratoconus among primary eye care practitioners in Ghana and Nigeria.
A questionnaire adapted from previous studies was modified and created using Google Forms. The online survey was distributed to prospective participants using e-mails and other social media platforms. Data were analyzed using the Statistical Product and Service Solutions software (version 25.0; IBM Corp, Armonk, NY; Released 2017).
One hundred and sixty-nine optometrists responded to the survey (61.54% from Nigeria and 38.46% from Ghana). Most (88.6%) practiced without corneal topographers. Most respondents (77.7%, n=136) reported not fitting rigid gas-permeable (RGP) contact lenses in a year and 68% were willing to refer for contact lens fitting to another practitioner. The major barriers to RGP fitting were lack of experience (44.4%, n=72), cost to practice (15.4%, n=25), and other reasons (12.4%), whereas 27.8% (n=45) preferred not to answer. Seventy-six percent of respondents (n=133) were willing to fit RGPs if the respondents received the training to do so. About half of the respondents (53.8%) reported progression of cornea signs as the reason for referral to an ophthalmologist. Half of the respondents (n=51.4%) did not have a cornea surgeon in the area the respondents practiced, and 76.3% reported not comanaging patients at all with ophthalmologists.
This study highlights the current standard of care of patients with keratoconus in West Africa. The findings from this study suggest that clinical guidelines and further training of eye care practitioners in West Africa are needed to better manage patients with keratoconus.
调查加纳和尼日利亚的初级眼科保健从业者中圆锥角膜患者的转诊和管理模式。
对先前研究中采用的问卷进行修改，并使用谷歌表单创建。通过电子邮件和其他社交媒体平台向潜在参与者分发在线调查问卷。使用统计产品与服务解决方案软件（版本25.0；IBM公司，纽约州阿蒙克；2017年发布）进行数据分析。
169名验光师回复了调查（61.54%来自尼日利亚，38.46%来自加纳）。大多数（88.6%）在没有角膜地形图仪的情况下开展业务。大多数受访者（77.7%，n = 136）报告称一年内未验配硬性透气性（RGP）隐形眼镜，68%的人愿意将隐形眼镜验配转诊给其他从业者。验配RGP的主要障碍是缺乏经验（44.4%，n = 72）、业务成本（15.4%，n = 25）和其他原因（12.4%），而27.8%（n = 45）选择不回答。如果受访者接受相关培训，76%的受访者（n = 133）愿意验配RGP。约一半的受访者（53.8%）报告称角膜体征进展是转诊至眼科医生的原因。一半的受访者（n = 51.4%）所在业务区域没有角膜外科医生，76.3%的受访者报告根本没有与眼科医生共同管理患者。
本研究突出了西非圆锥角膜患者当前的护理标准。本研究结果表明，需要制定临床指南并对西非的眼科保健从业者进行进一步培训，以更好地管理圆锥角膜患者。
