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Practitioner perceptions about optometric networks in South Africa 从业者对南非验光网络的看法
Pub Date : 2023-04-21 DOI: 10.4102/aveh.v82i1.810
Simon A. Maluleke, V. Moodley
Background: Private healthcare in South Africa is largely financed by medical schemes. Optometrists reluctantly contract with administrators and networks to service these patients, despite them feeling networks are undesirable and exploitative. Networks contend that various mechanisms employed are necessary to ensure sustainability and prevent fraud, wastage and abuse. A working relationship between practitioners and networks should ideally be cordial and appreciated by each party as being mutually beneficial to the success of their respective businesses.Aim: To assess practitioners’ knowledge and perceptions regarding optometric networks.Setting: The study was conducted amongst optometric professionals in the private sector in South Africa.Methods: A descriptive, mixed-method study was conducted using a semi-structured questionnaire. Interviews with senior personnel from the networks were conducted.Results: Approximately 77% of respondents belonged to networks with 91% being knowledgeable about networks and their role within optometry. Opticlear had 72% members, while Iso Leso and preferred provider negotiators (PPN) had 67% and 41%, respectively. Most optometrists (69%) neither believed in the need for networks nor that they provide value to the profession, while 94.7% joined networks merely to receive direct payment and access patients, with no other benefits noted.Conclusion: Practitioners reluctantly contract to networks for direct payment and to access patients. Furthermore, practitioners feel that networks bully and victimise them while networks highlight their responsibility to reduce healthcare costs and negative practices of fraud, waste and abuse.Contribution: Providing sustainable, cost-effective and quality eye care services requires collaboration between networks and practitioners and appreciating each other’s roles in the delivery of eye care services. 
背景:南非的私人医疗保健主要由医疗计划提供资金。验光师不情愿地与管理人员和网络签订合同,为这些患者提供服务,尽管他们觉得网络是不受欢迎和剥削的。网络争辩说,为了确保可持续性和防止欺诈、浪费和滥用,必须采用各种机制。理想情况下,从业人员和网络之间的工作关系应该是亲切的,并为各方所赞赏,因为这对各自业务的成功是互利的。目的:评估从业人员对验光网络的认识和认知。环境:这项研究是在南非私营部门的验光专业人员中进行的。方法:采用半结构化问卷,采用描述性混合方法进行研究。采访了来自网络的高级人员。结果:大约77%的受访者属于网络,91%的人了解网络及其在验光中的作用。Opticlear拥有72%的成员,而Iso Leso和首选供应商谈判代表(PPN)分别拥有67%和41%的成员。大多数验光师(69%)既不相信网络的必要性,也不认为网络为职业提供了价值,而94.7%的验光师加入网络仅仅是为了直接获得报酬和接触患者,没有其他好处。结论:从业者不情愿地签约网络直接支付和接触病人。此外,从业人员认为网络欺凌和伤害他们,同时网络强调他们有责任降低医疗成本和欺诈、浪费和滥用的负面做法。贡献:提供可持续、具有成本效益和高质量的眼科保健服务需要网络和从业人员之间的合作,并欣赏彼此在提供眼科保健服务中的作用。
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引用次数: 0
Keratoconic patient profile and management at public sector facilities in South Africa 南非公共部门设施角膜移植患者概况和管理
Pub Date : 2023-03-31 DOI: 10.4102/aveh.v82i1.780
Pheagane M. Nkoana, V. Moodley, K. Mashige
difference of 7.59 ± 6.08 D ( p < 0.001) between the better and the worse eye. The study found no significant difference in KC severity by age ( p = 0.451 ) and gender ( p = 0.819 ). Patients fitted with scleral lenses had the highest VA improvement of 0.44 ± 0.17. Conclusion: Most patients presented with bilateral and severe KC. Scleral lenses provided higher VA improvement than other methods. Contribution: The study aimed to present the clinical profile and management of keratoconic patients attending public sector facilities. Knowledge of the patterns of KC presentation may assist in the development of intervention strategies and guidelines for best practice in the management of KC, especially in public sector facilities.
好眼与差眼的差异为7.59±6.08 D (p < 0.001)。研究发现,年龄(p = 0.451)和性别(p = 0.819)在KC严重程度上无显著差异。配戴巩膜晶状体的患者视力改善幅度最大,为0.44±0.17。结论:大多数患者表现为双侧和重度KC,巩膜晶状体比其他方法有更好的VA改善效果。贡献:本研究旨在介绍在公立机构就诊的角膜成形患者的临床概况和管理。了解KC的表现模式可能有助于制定干预策略和指导方针,以最佳地管理KC,特别是在公共部门设施中。
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引用次数: 1
Environmental impact and end-of-life options of disposed polymeric spectacle and contact lenses 处置聚合物眼镜和隐形眼镜的环境影响和报废选择
Pub Date : 2023-03-10 DOI: 10.4102/aveh.v82i1.775
Rayishnee Pillay, R. Hansraj, N. Rampersad, A. Bissessur
. Contribution: This study provides new information on the environmental consequences of current modes of lens disposal and suggests EOL alternatives thereof.
. 贡献:本研究提供了当前透镜处理方式对环境影响的新信息,并提出了EOL替代方案。
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引用次数: 0
Perceptions of diabetic retinopathy-related educational resources in a community in Oman 阿曼一个社区对糖尿病视网膜病变相关教育资源的认识
Pub Date : 2023-02-27 DOI: 10.4102/aveh.v82i1.767
Gopi S. Vankudre, Sheikha Al Saadi
Background: Diabetic retinopathy (DR) contributes 1% of the total 37 million blind individuals globally. In Oman, 12.3% of the community aged 18 years and older are affected by diabetes mellitus. Health literacy is essential in advancing an individual’s disease-linked knowledge, attitudes and treatment compliance. Effective educational resources would earn positive health outcomes.Aim: This study evaluates the Omani community’s perception of educational resources related to DR.Setting: This is a prospective, cross-sectional, questionnaire-based study.Methods: A self-administered, online questionnaire received responses from 253 participants using a convenient snowball sampling approach. The initial section of the questionnaire gathered information on participant’s demographic information. The second section collected the feedback on the perception of the availed DR material utilising a five-point Likert scale. Descriptive and inferential (chi-square test, Fisher’s exact test and logistic regression analysis) statistics were used to analyse the data.Results: Of the total 253 study participants, 51 (20.2%) were male and 202 (79.8%) were female. Only 155 (61.3%) participants received DR-related health information. Optometrists (30.3%) served as the primary source of information. There was no relationship between perception and socio-economic or educational levels (p 0.05). Of the 155 participants receiving DR-related health information, 47.7% (n = 74) of the survey population is highly satisfied with the received DR-related health promotional resource.Conclusion: Only 61.3% of the members received DR-related health information. Most participants had a positive perception of DR-related health educational resources.Contribution: This study observed positive participant’s perception towards diabetic retinopathy related health educational resources. The study proposes to conduct further health promotional activities using social media platforms.
背景:糖尿病视网膜病变(DR)占全球3700万盲人总数的1%。在阿曼,12.3%的18岁及以上的社区居民患有糖尿病。卫生素养对于提高个人与疾病相关的知识、态度和治疗依从性至关重要。有效的教育资源将带来积极的健康结果。目的:本研究评估阿曼社区对与博士相关的教育资源的看法。背景:这是一项前瞻性、横断面、基于问卷的研究。方法:采用方便的滚雪球抽样方法,对253名参与者进行了自我管理的在线问卷调查。调查问卷的最初部分收集了参与者的人口统计信息。第二部分收集了利用五点李克特量表对可用DR材料感知的反馈。采用描述性统计和推断性统计(卡方检验、Fisher精确检验和逻辑回归分析)对数据进行分析。结果:253名研究参与者中,男性51人(20.2%),女性202人(79.8%)。只有155名(61.3%)参与者收到了dr相关的健康信息。验光师(30.3%)是主要的信息来源。知觉与社会经济或教育水平没有关系(p 0.05)。在收到dr相关健康信息的155名参与者中,47.7% (n = 74)的调查人群对收到的dr相关健康宣传资源高度满意。结论:只有61.3%的会员收到了dr相关的健康信息。大多数被试对dr相关的健康教育资源有正面的认知。贡献:本研究观察了积极参与者对糖尿病视网膜病变相关健康教育资源的认知。该研究建议利用社交媒体平台开展进一步的健康宣传活动。
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引用次数: 0
Disposal of spectacles and contact lenses: Optometrist and lens wearer perspectives 眼镜和隐形眼镜的处理:验光师和镜片佩戴者的观点
Pub Date : 2023-02-24 DOI: 10.4102/aveh.v82i1.784
Rayishnee Pillay, R. Hansraj, N. Rampersad
practices in South Africa, and emphasises the need for environmental awareness.
并强调了提高环境意识的必要性。
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引用次数: 0
Eye care services and benefits paid by medical schemes in South Africa 南非医疗计划支付的眼科保健服务和福利
Pub Date : 2023-02-10 DOI: 10.4102/aveh.v82i1.756
Michael M. Willie
of the efficacy with which healthcare services are covered. 8 There is a significant gap in the quality of care (between the services required by patients and those supplied by healthcare facilities and workers). Background: Vision impairment (VI) affects people worldwide, and demographic factors like age are significantly linked to VI. Routine eye exams and other eye care treatments can detect and prevent common eye illnesses. However, many lack access to these services. Aim: This study’s major objective was to analyse the distribution and funding of eye care services by medical schemes in South Africa. Setting: The study was conducted in the private sector in South Africa for benefits paid by medical schemes to optometrists, ophthalmologists and orthoptists. Methods: A retrospective, longitudinal study of eye care services claim data from the Council for Medical Schemes (CMS) annual reports. The review period was 2020, and scheme-level data were gathered and analysed at the aggregated rather than benefit option level. Results: In 2020, eye care benefits comprised 3.1 % of total benefits paid; this proportion remained at the same levels throughout the review period. Closed schemes spent more per beneficiary per year than open schemes for optometrists, orthoptists and ophthalmologists. Self-administered schemes had 11 % copayment for ophthalmology services, whereas outsourced schemes had less than 10 % . Conclusion: Optometrists had higher copayments than ophthalmologists and orthoptists. Medical schemes with capitated models had a lower average expenditure than other types of models, and the operating model affected expenditure; self-administered schemes spent less on optometry benefits when adjusted for beneficiaries. The study suggests reviewing eye care benefit funding models (risk vs savings), administration activities and managed care models for cost savings and health quality. Contribution: This research contributes to the discussion and implementation of universal health insurance coverage through national health insurance in South Africa. The research shows that there are not enough eye care services in the public sector and that there are different funding gaps in the private sector.
医疗保健服务的覆盖效果。8 .护理质量(在病人需要的服务与保健设施和工作人员提供的服务之间)存在很大差距。背景:视力障碍(VI)影响着全世界的人们,年龄等人口因素与VI密切相关。常规眼科检查和其他眼部护理治疗可以发现和预防常见的眼部疾病。然而,许多人无法获得这些服务。目的:本研究的主要目的是分析南非医疗计划眼科护理服务的分布和资金。背景:这项研究是在南非私营部门进行的,目的是利用医疗计划向验光师、眼科医生和矫形师支付的福利。方法:对医疗计划委员会(CMS)年度报告中的眼科保健服务索赔数据进行回顾性、纵向研究。审查期为2020年,在汇总而非福利选择一级收集和分析计划级数据。结果:2020年,眼科保健福利占支付总额的3.1%;在整个审查期间,这一比例保持在同一水平。对于验光师、矫形师和眼科医生而言,封闭计划每年每个受益人的支出高于开放计划。自行管理计划的眼科服务共付额为11%,而外包计划的这一比例不到10%。结论:验光师的共付费用高于眼科医师和骨科医师。有资本模式的医疗计划的平均支出低于其他类型的医疗计划,其运营模式影响了支出;根据受益人调整后,自我管理计划在验光福利上的支出更少。该研究建议审查眼科保健福利资助模式(风险与节省)、管理活动和管理护理模式,以节省成本和提高健康质量。贡献:本研究有助于南非通过国家健康保险讨论和实施全民健康保险。研究表明,公共部门没有足够的眼科保健服务,私营部门也存在不同的资金缺口。
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引用次数: 0
Spectacle lens and contact lens recycling in South Africa 南非眼镜镜片和隐形眼镜回收
Pub Date : 2023-01-31 DOI: 10.4102/aveh.v82i1.777
Rayishnee Pillay, R. Hansraj, N. Rampersad
light of global climate change. 7 Some optical companies have implemented recycling programmes for spectacle lenses and contact lenses in the United States (US), United Kingdom (UK) and European Union 8,9,10,11 ; however, to date no such recycling schemes exist in South Africa (SA). Spectacle frame degradation has been previously explored 3 ; hence, the purpose of this review article is to present the current outlook, barriers experienced and potential measures that could be adopted to encourage the recycling of plastic spectacle lenses and contact lenses in SA.
鉴于全球气候变化。7 .一些光学公司在美国(US)、联合王国(UK)和欧洲联盟(8,9,10,11)执行了眼镜镜片和隐形眼镜的回收方案;然而,到目前为止,南非还没有这样的回收计划。眼镜框架退化之前已经被探索过3;因此,这篇综述文章的目的是介绍目前的前景,遇到的障碍和可能采取的措施,以鼓励塑料眼镜和隐形眼镜在南非的回收。
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引用次数: 0
Diabetic retinal detachment surgery at a central academic hospital, Johannesburg, South Africa 糖尿病视网膜脱离手术在中央学术医院,约翰内斯堡,南非
Pub Date : 2023-01-30 DOI: 10.4102/aveh.v82i1.761
Mathabo Mofokeng, Mokokomadi A. Makgotloe
Background: Tractional retinal detachment surgery outcomes are unpredictable and need to be reviewed regularly in clinical practice settings.Aim: To describe the visual acuity and anatomical outcomes of retinal detachment surgery for diabetic tractional retinal detachment at a central academic hospital.Setting: Johannesburg, South Africa.Methods: This study involves a retrospective case series of patients who had surgery for diabetic tractional retinal detachment at Charlotte Maxeke Johannesburg Academic Hospital between 01 January 2010 and 31 December 2014.Results: A total of 65 patients with diabetic retinal detachment were included in this study. The study consisted of 63% (n = 41) male patients and 37% (n = 24) female patients. The mean age (± standard deviation) was 54 ± 12.2 years. Forty-four patients (68%) had tractional retinal detachment, and 21 (32%) patients had a combined tractional and rhegmatogenous retinal detachment. Twenty-one (32%) patients had detachments associated with vitreous haemorrhage (VH), and 39 (60%) patients had macular-involving detachments. Forty-six (71%) patients obtained vision improvement or stabilisation and reattachment of the retina, 24 (36.9%) patients had visual acuity improvement, 22 (33.9%) patients retained the same visual acuity and 19 (29.2%) patients lost vision. Fifty-five (85%) patients had successful anatomical reattachment of the retina, and 10 (15%) patients had re-detachments after surgery.Conclusion: The majority of patients whose files were reviewed benefited from surgical intervention for diabetic tractional retinal detachment in terms of stabilisation or improvement of vision.Contribution: Tractional detachment surgery outcomes in our setting are comparable to those from elsewhere around the world.
背景:牵引性视网膜脱离手术的结果是不可预测的,需要在临床实践中定期审查。目的:介绍某中心学术医院视网膜脱离手术治疗糖尿病牵引性视网膜脱离的视力和解剖结果。背景:南非约翰内斯堡。方法:本研究回顾性分析2010年1月1日至2014年12月31日在Charlotte Maxeke约翰内斯堡学术医院接受手术治疗的糖尿病牵引性视网膜脱离患者。结果:本研究共纳入65例糖尿病视网膜脱离患者。该研究包括63% (n = 41)男性患者和37% (n = 24)女性患者。平均年龄(±标准差)为54±12.2岁。牵引性视网膜脱离44例(68%),牵引性和孔源性视网膜脱离21例(32%)。21例(32%)患者有玻璃体出血(VH)相关的脱离,39例(60%)患者有累及黄斑的脱离。46例(71%)患者视力改善或稳定,视网膜再植,24例(36.9%)患者视力改善,22例(33.9%)患者视力保持不变,19例(29.2%)患者视力丧失。55例(85%)患者视网膜解剖复位成功,10例(15%)患者术后视网膜再脱离。结论:通过手术治疗糖尿病性牵引性视网膜脱离的患者在稳定或改善视力方面获益。贡献:我们的牵引性脱离手术的结果与世界其他地方的结果相当。
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引用次数: 0
Ocular monkeypox virus infection – To worry or to not worry? 眼猴痘病毒感染-担心还是不担心?
Pub Date : 2023-01-05 DOI: 10.4102/aveh.v82i1.786
A. Elgazzar, W. Abdella, Ehab Tharwat
Dear editor, We had not yet recovered from coronavirus disease 2019 (COVID-19) and its consequences, which have affected all aspects of life, whether health or economic, before a new epidemic appeared in some countries called the monkeypox virus. The first human monkeypox case was reported in 1971 in the Democratic Republic of the Congo. 1 West and Central Africa are considered endemic areas for the monkeypox virus. 2 On 07 May 2022, a monkeypox outbreak was reported in nonendemic areas such as Europe, the Americas and Australia. 3 Appearance of this outbreak in those countries may be because of the stoppage of smallpox vaccination, the migration of people from endemic areas to those countries or increased contact between people and monkeys after their migration into the forest. 4 Monkeypox is transmitted from animal to human through bites or scratches. 5 It then spreads from human to human through salivary or respiratory droplets or direct contact with the exudate of the skin lesion. 6 We suggest that monkeypox can spread to the eye through direct contact between the eyes and the infected hands or the respiratory droplets of the patients. [...]topical steroids must not be used, as they help virus persistence and increase corneal complications. 5 As shown in Figure 1 , our message to ophthalmologists is that if any patient presents with conjunctivitis and skin rash, examine the patient for other monkeypox manifestations.
我们还没有从2019冠状病毒病(COVID-19)及其后果中恢复过来,就在一些国家出现了一种名为猴痘病毒的新流行病之前,它已经影响了生活的各个方面,无论是健康还是经济。第一例人类猴痘病例于1971年在刚果民主共和国报告。1西非和中非被认为是猴痘病毒的流行地区。2 2022年5月7日,据报告在欧洲、美洲和澳大利亚等非流行地区暴发了猴痘疫情。3这些国家出现这种疫情可能是由于停止接种天花疫苗、人们从流行地区迁移到这些国家或人与猴子迁移到森林后接触增加所致。猴痘通过咬伤或抓伤从动物传染给人类。然后通过唾液或呼吸道飞沫或直接接触皮肤病变的渗出物在人与人之间传播。我们认为,猴痘可以通过眼睛与受感染的手或患者的呼吸道飞沫直接接触传播到眼睛。[…局部类固醇不能使用,因为它们有助于病毒持续存在并增加角膜并发症。如图1所示,我们给眼科医生的信息是,如果任何患者出现结膜炎和皮疹,检查患者是否有其他猴痘表现。
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引用次数: 0
Perceptions of diabetic retinopathy-related educational resources in a community in Oman 阿曼一个社区对糖尿病视网膜病变相关教育资源的认识
Pub Date : 2022-11-30 DOI: 10.4102/aveh.v81i1.767
Gopi S. Vankudre, Sheikha Al Saadi
Background: Diabetic retinopathy (DR) contributes 1% of the total 37 million blind individuals globally. In Oman, 12.3% of the community aged 18 years and older are affected by diabetes mellitus. Health literacy is essential in advancing an individual’s disease-linked knowledge, attitudes and treatment compliance. Effective educational resources would earn positive health outcomes.Aim: This study evaluates the Omani community’s perception of educational resources related to DR.Setting: This is a prospective, cross-sectional, questionnaire-based study.Methods: A self-administered, online questionnaire received responses from 253 participants using a convenient snowball sampling approach. The initial section of the questionnaire gathered information on participant’s demographic information. The second section collected the feedback on the perception of the availed DR material utilising a five-point Likert scale. Descriptive and inferential (chi-square test, Fisher’s exact test and logistic regression analysis) statistics were used to analyse the data.Results: Of the total 253 study participants, 51 (20.2%) were male and 202 (79.8%) were female. Only 155 (61.3%) participants received DR-related health information. Optometrists (30.3%) served as the primary source of information. There was no relationship between perception and socio-economic or educational levels (p  0.05). Of the 155 participants receiving DR-related health information, 47.7% (n = 74) of the survey population is highly satisfied with the received DR-related health promotional resource.Conclusion: Only 61.3% of the members received DR-related health information. Most participants had a positive perception of DR-related health educational resources.Contribution: This study observed positive participant’s perception towards diabetic retinopathy related health educational resources. The study proposes to conduct further health promotional activities using social media platforms.
背景:糖尿病视网膜病变(DR)占全球3700万盲人总数的1%。在阿曼,12.3%的18岁及以上的社区居民患有糖尿病。卫生素养对于提高个人与疾病相关的知识、态度和治疗依从性至关重要。有效的教育资源将带来积极的健康结果。目的:本研究评估阿曼社区对与博士相关的教育资源的看法。背景:这是一项前瞻性、横断面、基于问卷的研究。方法:采用方便的滚雪球抽样方法,对253名参与者进行了自我管理的在线问卷调查。调查问卷的最初部分收集了参与者的人口统计信息。第二部分收集了利用五点李克特量表对可用DR材料感知的反馈。采用描述性统计和推断性统计(卡方检验、Fisher精确检验和逻辑回归分析)对数据进行分析。结果:253名研究参与者中,男性51人(20.2%),女性202人(79.8%)。只有155名(61.3%)参与者收到了dr相关的健康信息。验光师(30.3%)是主要的信息来源。知觉与社会经济或教育水平没有关系(p 0.05)。在收到dr相关健康信息的155名参与者中,47.7% (n = 74)的调查人群对收到的dr相关健康宣传资源高度满意。结论:只有61.3%的会员收到了dr相关的健康信息。大多数被试对dr相关的健康教育资源有正面的认知。贡献:本研究观察了积极参与者对糖尿病视网膜病变相关健康教育资源的认知。该研究建议利用社交媒体平台开展进一步的健康宣传活动。
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引用次数: 0
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African Vision and Eye Health
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