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Glaucoma detection: The content of optometric eye examinations for a presbyopic patient of African racial descent
  1. Rakhee Shah (rakhee19{at},
  2. David F Edgar (d.f.edgar{at},
  3. Paul G. D. Spry (paul.spry{at},
  4. Robert A Harper (robert.harper{at},
  5. Aachal Kotecha (aachal.kotecha.1{at},
  6. Sonal Rughani (srughani{at},
  7. Bruce JW Evans (bruce.evans{at}
  1. Institute of Optometry, United Kingdom
  2. City University, United Kingdom
  3. Bristol Eye Hospital, United Kingdom
  4. Manchester Royal Eye Hospital, United Kingdom
  5. City University, United Kingdom
  6. Institute of Optometry, United Kingdom
  7. Institute of Optometry, United Kingdom


    Background: Standardized patient (SP) methodology is the gold standard for evaluating clinical practice. We investigated the content of optometric eyecare for an early presbyopic SP of African racial descent, an ‘at risk’ patient group for POAG.

    Methods: A trained actor presented unannounced as a 44-year-old of African racial descent, complaining of recent near vision difficulties, to 100 community optometrists for an audio-recorded eye examination. The eye examinations were subsequently assessed via a checklist based on evidence-based POAG reviews, clinical guidelines, and expert panel opinion.

    Results: 95% of optometrists carried out optic disc assessment and tonometry, which conforms to College of Optometrists’ advice that those over 40 years should receive at least two of tonometry, optic disc assessment, or visual field testing. 35% of optometrists carried out all of these tests and 6% advised SP of increased POAG risk in those of African racial descent.

    Conclusion: SP encounters are an effective measure of optometric clinical practice. As in other healthcare disciplines, substantial differences exist between optometrists in the depth of their clinical investigations, challenging the concept of a ‘standard sight test’. There is a need for CPD in glaucoma screening.

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