Quality assurance 2011 12 optometry department protocol compliance of new cases for age under 12
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Quality Assurance 2011/12 Optometry Department Protocol Compliance of New Cases (for age under 12). June Kwok 22 Mar 2012. Purpose. To determine the protocol compliance rate of new paediatric cases in HKEH (for age under 12) attending optometry department. Reference - Protocol.

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Quality Assurance 2011/12 Optometry Department Protocol Compliance of New Cases (for age under 12)

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Quality assurance 2011 12 optometry department protocol compliance of new cases for age under 12

Quality Assurance 2011/12Optometry DepartmentProtocol Compliance of New Cases (for age under 12)

June Kwok

22 Mar 2012


Purpose

Purpose

To determine the protocol compliance rate of new paediatric cases in HKEH (for age under 12) attending optometry department.


Reference protocol

Reference - Protocol

For new patient under 12:

  • Habitual VA

  • Spectacle power measurement (if any)

  • Auto-refraction

  • TL if habitual VA worse than 6/9 (0.7-)


Methods

Methods

  • Retrospective study

  • Paediatric new cases (age 5 to 12)

  • Period from Apr to Sep 2011

  • Collect information on

  • VA

  • Spectacle power

  • Auto-refraction

  • Subjective refraction

  • Primary diagnosis

  • Follow up pattern


Findings and observations

Findings and observations

  • Total 149 patients ( 76 F, 73 M)

  • Age: 5 – 12.75

  • 44 wear spectacles

  • Spectacle Rx:

    RE: +4.5D to -5.5D sphere, 0 to -3.5D cylinder

    LE: +8.25D to -5.25D sphere, 0 to -3.5D cylinder

  • 105 unaided or own spectacle not brought

  • Habitual VA:

    RE: 4/60 to 1.2

    LE: 3/60 to 1.2-

  • Auto refractions were done to all patients

  • 65 subjective refractions (TL) were done


Habitual va distribution

Habitual VA distribution


Habitual va distribution1

Habitual VA distribution


Va status with and without glasses

VA status with and without glasses


Va status before tl

VA status before TL


Va status after tl for re le

VA status after TL for RE & LE


Va status after tl

VA status after TL

  • Total 65 TL

  • 10 out of 65 VA still fail after TL (either one eye or both eyes)

    = 15.38 %

  • 55 out of 65 VA pass after TL

    = 84.62 %


Primary diagnosis

Primary Diagnosis

Primary diagnosis is categorized as follow:

  • Refractive errors

  • Squint

  • Amblyopia

  • Conjunctival diseases: acute conjunctivitis; allergic conjunctivitis; vernal keratoconjunctivitis (VKC)

  • Eye lid disorders: Epiblepharon; chalazion; ptosis; capillary haemangioma.

  • Uveitis: associated with Juvenile idiopathic arthritis (JIA)

  • Tearing: congenital nasolacrimal passage obstruction; congenital glaucoma.

  • Others: RP; family history of RP; moya moya; color vision defects; brain tumour; corneal scar.

  • NAD


Primary diagnosis1

Primary Diagnosis


Primary diagnosis2

Primary Diagnosis


Follow up pattern

Follow up pattern


Follow up pattern1

Follow up pattern


Summary

Summary

  • 62 out of 149 (42%) patients with habitual VA failed.

  • With adequate refractive correction, only 10 out of 149 (6.7%) patients had failed VA.

  • The primary diagnosis of 62% patients are of refractive, squint or amblyopic problems.

  • 35% patients were discharged or Fu PRN after the first visit.


Conclusion

Conclusion

100% protocol compliance rate were observed for new paediatric cases in HKEH attending optometry department for the first visit.

i.e.

  • Habitual VA (100%)

  • Auto-refraction (100%)

  • Read spectacles if any (100%)

  • Refraction if habitual VA worse than 0.7- (100%)

  • 3 of the refractions even habitual VA better than 0.7- (over 100%)


Acknowledgement

Acknowledgement

  • Optometry Colleagues

  • MRO Colleagues


Thank you

Thank You


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