Survey of Australian primary eyecare management of choroidal nevus patients

Our survey found that clinical imaging is widely utilized by many Australian eyecare practitioners for detecting and monitoring choroid nevus and highlighted knowledge gaps for risk factors and features of choroid nevus and early primary eye melanoma. Continuing education related to early detection could improve multidisciplinary management of these patients.

The aim is to survey Australian primary eyecare practitioners on their management of patients with choroidal nevus.

A random sample of optometrists and ophthalmologists registered to practice in Australia was surveyed using a purpose-designed questionnaire including demographics, types of imaging techniques used, and practitioner choroid nevus knowledge (K), attitude (A), and practice (P).

Ninety-three optometrists and 82 ophthalmologists responded. More than 50% practiced independently, most in metropolitan centers (n = 113/175). Multiple imaging techniques were used to detect and monitor choroidal nevus; >72% of practitioners routinely used optical coherence tomography and color fundus photography. KAP scores indicated moderate knowledge about choroid nevus risk factors and clinical features (mean = 5.2/9, standard deviation [SD] = 1.8). Clinical mnemonics that summarized signs of risk for nevus-to-melanoma transformation were used by <50% of practitioners overall. Scores indicated a very positive attitude to nevus management (mean = 6.5/8, SD = 1.2) but a moderate practice score (mean = 13.9/25, SD = 2.9). A significant difference between optometrists and ophthalmologists was found for knowledge, but not for attitude or practice scores. Choroid nevus patients were referred to a specialist ophthalmologist by ~30% of all practitioners.

The majority of Australian primary eyecare practitioners used multiple imaging techniques to detect and monitor choroidal nevi. There were, however, gaps in knowledge associated with identifying risk factors for choroidal nevus growth. Our findings align with recent UK studies that highlight the importance of diligent screening and review, timely referral for potential melanoma-related risks, and encourage multidisciplinary care for choroidal nevus patients.