Optometric Practice Patterns for Acute Central and Branch Retinal Artery Occlusion.

Area of Science:

• Ophthalmology
• Neurology
• Public Health

Background:

• Optometrists are primary diagnosticians for acute vision loss, including central retinal artery occlusion (CRAO).
• Timely diagnosis and referral are crucial for acute therapeutic intervention in CRAO.
• Current optometric practice patterns for CRAO management require investigation.

Purpose of the Study:

• To survey U.S. optometrists regarding their practice patterns for managing central retinal artery occlusion (CRAO).
• To understand the timeliness of diagnosis and referral for CRAO by optometrists.
• To identify barriers to acute management of CRAO.

Main Methods:

• An anonymous seven-question survey was distributed electronically in 2020.
• The survey targeted members of the American Academy of Optometry and the American Optometric Association.
• Response rate was 6.1% (1,926 out of 31,603 optometrists).

Main Results:

• Most respondents practice in optometry-predominant clinics and are near stroke centers.
• A majority of optometrists diagnosed fewer than 5 CRAOs annually; 52% diagnosed none in the prior year.
• Over 70% of diagnosed CRAOs were evaluated more than 4 hours after symptom onset.
• Many optometrists referred CRAO patients to ophthalmology clinics (39.9%) rather than stroke-affiliated emergency departments (44.0%).

Conclusions:

• Optometrists are key in identifying acute vision loss but face challenges in timely CRAO management.
• Low survey response rates may indicate limited exposure or research interest in CRAO among optometrists.
• Delayed evaluations and inappropriate referrals to ophthalmology clinics hinder acute CRAO treatment.
• Education is needed to emphasize CRAO as a stroke requiring urgent referral to emergency departments with stroke centers.