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

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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  1. Quality Assurance 2011/12Optometry DepartmentProtocol Compliance of New Cases (for age under 12) June Kwok 22 Mar 2012

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

  3. 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-)

  4. 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

  5. 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

  6. Habitual VA distribution

  7. Habitual VA distribution

  8. VA status with and without glasses

  9. VA status before TL

  10. VA status after TL for RE & LE

  11. 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 %

  12. 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

  13. Primary Diagnosis

  14. Primary Diagnosis

  15. Follow up pattern

  16. Follow up pattern

  17. 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.

  18. 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%)

  19. Acknowledgement • Optometry Colleagues • MRO Colleagues

  20. Thank You

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