The practice of optometry: National Board of Examiners in Optometry survey of optometric patients

Purpose. A study commissioned by the National Board of Examiners in Optometry was designed to obtain information about patients seen in general practice. Methods. Providers completed an encounter form for patients seen during a 2-day sample. Data were obtained from 11,012 patients in rural, urban, and suburban environments from a diverse population of 480 optometrists representative of profession-wide practitioners in terms of geographic distribution and practice settings. Although practitioners were randomly selected, the response rate among those who were invited to participate was only 17.7%. Optometrists who specialized and did not classify themselves as general practitioners were excluded from the study. Results. The study provides insights into the most common diagnostic and therapeutic procedures performed, medications prescribed, and referrals made in general practices. Seventy-one percent of all examinations were categorized as comprehensive eye examinations, approximately 13% the result of disease, and 11% was for contact lens care. Almost 17% of all patients received a formal visual field test (Goldmann or automated). Refractive error was the most prevalent diagnosis reflective of the ocular problems found in the general population and systemic conditions were the second largest category. Although 12% of all patients were referred to an ophthalmologist for further care, other types of referrals were infrequent. Referrals to a primary care physician, laboratory, and imaging or for refractive surgery accounted for only 8% of all referrals. Conclusion. Ocular disease treatment was found to be an integral part of the optometrist's practice. Prescribing topical medications, both legend and "over the counter," was a primary treatment option. The most common medications prescribed were for glaucoma, with antibiotics, anti inflammatory, and antiallergy drops making up the remainder in descending order.