The Knowledge Economy and Social Impact

There is not a one-size-fits-all definition of “social impact.” In fact, in a Google search for “What is social impact?” more than 400 results appear. This chapter will highlight global initiatives led by OneSight, an NGO that is utilizing new technologies to combat the vision care crisis, and CanopyLAB, a software company that has teamed up with over 120 NGOs around the world to create and provide online courses utilizing artificial intelligence.

Evaluation of educational interventions on eye health for dietetic and pharmacy professions: a pre-post study

Background We piloted an educational intervention that aimed to enhance awareness about nutrition-age-related macular degeneration (AMD) links among practising and student dietitians then expanded the scope of this intervention to include general eye health, which was delivered to pharmacy students. Methods A pilot intervention was conducted in 2019 at the Dietitians Australia Conference (Gold Coast, Australia) where practising and student dietitians underwent a 2-hour small group educational workshop on nutrition and AMD links. Pre-post questionnaires were administered to participants, with voluntary completion of both questionnaires an indicator of consent to participate in the intervention. The primary intervention outcome was a change in AMD-related nutrition knowledge pre-post intervention. A larger intervention was then conducted at the University of Sydney (Sydney, Australia) where pharmacy students underwent a 4-hour educational module to improve general eye health knowledge, as well as student perceptions and attitudes towards a pharmacists’ role in low vision care. Similarly, pre-post questionnaires were administered, with voluntary completion of both questionnaires an indicator of consent to participate in the intervention. The primary intervention outcomes were changes in total knowledge, total perception and total attitude scores pre-post intervention. Results (1) Among 10 accredited and 5 student dietitians, there was significant overall knowledge improvement (mean pre-post score: 7.07 ± 1.94 vs. 10.8 ± 1.01, p = 0.001) specifically around appropriate dietary advice, food sources of key AMD-related nutrients, and awareness of supplements. (2) Among 179 second-year pharmacy students enrolled in the ‘Pharmacy Practice’ Unit of Study (Bachelor of Pharmacy, University of Sydney), total eye health knowledge (6.25 ± 1.93 vs. 6.64 ± 2.0; p = 0.011) significantly improved, along with total perception scores (41.54 ± 5.26 vs. 42.45 ± 4.95; p = 0.004). Total attitude scores were not significantly different. Conclusions The pilot intervention improved relevant nutrition-AMD knowledge among practising/student dietitians. The modified intervention for pharmacy students also significantly improved general eye health knowledge as well as students’ perception of a pharmacists’ role in low vision care.

An evaluation of community-based comprehensive vision care for the ageing population

ABSTRACTObjectiveThis study was conducted to evaluate the real-world effectiveness and potential cost-effectiveness of a community-based vision care programme for the ageing population aged 60 years or above.MethodsData from a total of 8899 subjects participating in a community based comprehensive vision care programme from 2015 to 2019 were extracted and analyzed to evaluate the effectiveness of the programme in terms of the prevalence of visual impairment (VI), the change in the prevalence of VI after refractive error correction, and the types of ocular disorders detected. VI was defined by a) visual acuity (VA) worse than 6/18 in any eye (worse eye) and b) VA worse than 6/18 in the better eye. The cost-effectiveness from the funder’s perspective was also estimated in terms of cost per VI avoided from such a programme.ResultsThe study found that referenced to VA of the worse eye, the prevalence of VI was 39.1% (3482/8899, 95% CI: 38.1%-40.1%) based on presenting VA and reduced to 13.8% (1227/8899, 95% CI: 13.1%-14.5%) based on best-corrected VA. Referenced to the VA in the better eye, the prevalence of VI was 17.3% (1539/8899, 95% CI: 16.5%-18.1%) based on presenting VA and decreased to 4.2% (373/8899, 95% CI: 3.8%-4.6%) after best-corrected VA. Uncorrected refractive error was the major cause of presenting VI. From the funder’s perspective, the cost per VI case prevented was HK$1921 based on VA in the worse eye and HK$3715 based on the better eye.ConclusionA community-based programme was effective to detect the VI and reduced a relative 65% to 76% VI after refractive error correction for the community-dwelling ageing population. The ageing population can benefit from regular comprehensive vision care.

From Provider to Advocate: The Complexities of Traumatic Brain Injury Prompt the Evolution of Provider Engagement

Treating a patient with traumatic brain injury requires an interdisciplinary approach because of the pervasive, profound and protean manifestations of this condition. In this review, key aspects of the medical history and review of systems will be described in order to highlight how the role of any provider must evolve to become a better patient advocate. Although this review is written from the vantage point of a vision care provider, it is hoped that patients, caregivers and providers will recognize the need for a team approach.

From Provider to Advocate: The Complexities of Mild Traumatic Brain Injury Prompt the Evolution of Provider Engagement

Treating a patient with traumatic brain injury requires an interdisciplinary approach because of the pervasive, profound and protean manifestations of this condition. In this review, key aspects of the medical history and review of systems will be described in order to highlight how the role of any provider must evolve to become a better patient advocate. Although this review is written from the vantage point of a vision care provider, it is hoped that patients, caregivers and providers will recognize the need for the team approach; it truly takes a village.

Establishing a school-based vision screening program in Myanmar: a qualitative study on the perspectives of school children with refractive error, teachers, optometrists and ophthalmologists

Background: Refractive error (RE) is one of the global leading causes of vision impairment among children. The World Health Organization outlined the school-based vision care program aided by school teachers as one solution. In Myanmar, although the prevalence of RE among school children is expected at about two million, a regular eye check-up program has not been established. This study aimed to explore the barriers, feasibility, and limitations of the children with RE and service providers to establish a program.Methods: This qualitative study was conducted in eight public schools,that have been involved in the pilot school-based vision screening program, in Yangon. Focus group discussions with school children and teachers from these schools, key informant interviews with optometrists and ophthalmologists, involved in the program, and working at Yangon Eye Hospital and North Okala General Hospital, were carried out from January to August 2020. Qualitative data analysis was manually performed using the grounded theory according to the pre-defined themes.Results: Almost all school children showed positive perspectives but they expressed their psychosocial barriers of the cost, time, and care given by their parents on the next vision examination. All teachers mentioned optimism to be volunteers. The optometrist and ophthalmologists revealed the feasibility to establish the program despite having limitations in human resources, logistic requirements, and low awareness level on visual impairment of the children by parents.Conclusions: This study highlighted that a school-based vision care program can be initiated in Myanmar despite having some barriers and limitations.

Hearing and vision care provided to older people residing in care homes: a cross-sectional survey of care home staff

Background Hearing and vision loss in older people has been proven to affect physical and mental health and increase the speed of cognitive decline. Studies have demonstrated that certain practices and improved staff knowledge increase the effective care of residents’ ears and eyes, yet it is not known which practices are being implemented in care homes. This study aimed to identify the gaps in staff knowledge regarding hearing and vision difficulties in older residents, and which practices known to improve ear and eye care in older care home residents are not commonly implemented in care homes in England. Methods This study used a cross-sectional survey design. Survey questions were informed by the existing literature and were focused on practices, staff knowledge, and other aspects that have shown to affect residents’ hearing and vision care. A convenience sample of care home staff were recruited from care homes across England between November 2018 and February 2019 via email and in paper format. Descriptive statistics and Chi-Square analysis were applied to identify the factors influencing the care being provided to care home residents. Results A total of 400 care home staff responded from 74 care homes. The results revealed that less than half of staff respondents reported to use screening tools to identify hearing (46%) and vision impairments (43.8%); that care homes rarely have access to other assistive devices for hearing (16%) and vision loss (23.8%), and that audiology services do not regularly assess care home residents (46.8%). A majority of staff who responded were not confident in ear and eye care. Responses were found to be influenced by the respondents’ job role, length of time working in care homes and also the care home type. Findings confirmed a lack of standardised practice and the importance of shared communication for promulgation of best practice. Conclusion This study has identified that some practices known to facilitate ear and eye care are not commonly applied in a sample of English care homes. It has also shown that care home staff knowledge of ear and eye care is inconsistent. The information derived from this survey can be used to inform guidelines for best practice and inform needs for future research.