research topics for optometry students

List of Optometric Research Topics

Samantha hazard.

Optometric research may require you to focus on a topic, or to look at the whole picture. Since optometry is such a broad science, the choice of a singular topic may be more difficult than meets the eye. You may have to observe optometry as a whole before you can use your acute sense of perception to see what you really wish to research. Observe and choose from the many great topics around you.

Explore this article

• Vision Impairment and Chronic Disease
• Behavioral Optometry
• Optometric Medication
• Correlation Between Myopia (or Hyperopia) and Astigmatism

1 Vision Impairment and Chronic Disease

Some chronic diseases, such as multiple sclerosis or diabetes, can cause vision loss. While "vision impairment" may be defined as the partial or total loss of vision, chronic disease is a disease that is long-lasting or recurrent. Since both vision impairment and chronic disease may be lifelong impairments, it may be interesting to research either the correlation between one or some chronic diseases and vision loss, the long-term effects of the conjunction, or how treating one may help or impair the other.

2 Behavioral Optometry

Behavioral optometry is a line of optometry that believes in a holistic approach to vision and studies how the eyes and the brain interact to create and train vision, hold "mental pictures," and perceive the world around us. A study in 1945 at Johns Hopkins University deemed the practice of behavioral optometry "was of no value for the treatment of myopia (nearsightedness)." Since this study, however, researchers, optometrists and psychologists have begun to study and practice the use of behavioral optometry with children with ADD and ADHD, to help them narrow their focus and keep their eyes from wandering. This is a strong research topic because there is a lot of information on the spectrum of whether or not behavioral optometry actually works.

3 Optometric Medication

This topic may sound self-explanatory since you can research myriad optometric medications and their uses. However, the topic offers a chance to read and research deeper. Ocular medications may only treat one symptom, like IOP (intraocular pressure), but leave out treatments of other serious problems such as OHT (ocular hypertension). What are scientists and optometrists doing to treat a whole problem (in this case, glaucoma)? Is one symptom more easily treated or more important to be treated than another? Medication in general, just as optomology, is a multi-vectored science and both offer a great research topic.

4 Correlation Between Myopia (or Hyperopia) and Astigmatism

Have you noticed that myopia or hyperopia often occur in conjunction with astigmatism? While myopia and hyperopia are both refractive errors in the eye, and astigmatism is caused by an abnormal corneal curvature, both have to do with the stress on the eye and the ocular muscles surrounding it. This makes a great research topic not only because these conditions affect large populations, but also because researching these correlations offers several topics, including the origin and/or treatment of the conditions.

• 1 Centers for Disease Control and Prevention: Chronic Disease Prevention and Health Promotion
• 2 MedicineNet; Visionary Optometry; Mark Moran; November 2001

About the Author

Samantha Hazard has written professionally since 1998. Her published works can be found in "The High School Writer" literary magazine, "The Manitou Messenger" and "The Woodmen Edition" newspapers, iTunes, and Vimeo. Hazard has a Bachelor of Arts in English, media, and film from St. Olaf College.

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Vision is one of our most valuable senses. At UC Berkeley’s Herbert Wertheim School of Optometry & Vision Science, world-renowned faculty are exploring a rich array of research questions relating to how we see and why vision fails. The answers have the potential to change lives. Please use the buttons below to explore research degree programs and opportunities at Berkeley Optometry & Vision Science.

Vision Science Program

Investigators in Vision Science conduct human and animal research and modeling, yielding cutting-edge discoveries and applications in disciplines that include molecular genetics, clinical care, adaptive optics, neurobiology, cell biology, infectious disease, bioengineering, perception, and public health.

Clinical Research Center

Our goals are to explore new models and strategies for diagnosis, treatment, and prevention of ocular anomalies by conducting patient-based clinical studies/trials, as well as translational research. We also provide training for young professionals who are interested in, or want to pursue careers in, clinical research. We welcome undergraduates, optometry students, and post-doctoral fellows to become involved with our research team. The availability of these positions is dependent on our active projects.

Research Opportunities for OD Students

We offer current OD students a summer research training program funded by the National Eye Institute (NEI), as well as an option to graduate with honors for students who choose to submit a research dissertation or a scholarly case report.

Research Opportunities for Undergraduate Students

URAP The Undergraduate Research Apprentice Program (URAP) pairs faculty who need research assistance with undergraduates eager to engage in advanced research. New research projects are listed each term. Academic credit is available.

ViSUR The Vision Science Summer Undergraduate Research (ViSUR) Program is an 8-week in-person program that allows undergraduate students to work in a lab with a faculty advisor on a research project. Each student will receive a stipend of $5,000. Click the button below to learn more.

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Graduate education can lead to satisfying careers in academia and research, as well as in industry, the military, government and private practice. Scroll down to see current topics of research at schools and colleges of optometry, descriptions of research classifications, funding opportunities, and information on the translational science spectrum.

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List of graduate programs at optometry schools and colleges

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Research Topics

NIH/NEI (T35) National Research Service Award, Short-Term Institutional Research Training Grants: The goal of this training program is to support short-term research training for students in health professional schools during the summer, or for predoctoral and/or postdoctoral training in focused, often emerging scientific areas: researchtraining.nih.gov/programs/training-grants/T35

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Optometry Students      Grad Students           Faculty            

Other funding resources can be found at ARVO’s funding guide: https://www.arvo.org/journals-and-publications/arvo-funding-guide/

Training Pathways

The full spectrum of biomedical research ranges from basic laboratory discoveries to clinical applications and public health policy. Eye and vision research programs at schools and colleges of optometry span the entire range of translational research possibilities—from the fundamental basis and mechanisms of vision, to eye diseases, their diagnosis and treatment, and the impact of public health policies on our communities.

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Postgraduate resources

Explore resources for postgraduate research students of UNSW School of Optometry & Vision Science. You’ll find information about our current higher degree students and their research, research topics you might choose from, and how to find a supervisor.

OPTM7107 Ocular Therapy 1 (12 Uoc)  taken over one term (T1 and T2)

OPTM7117 Ocular Therapy 2 (12 UoC)  taken over one term (T3)

Program Delivery

O&M program delivery mode is full time, largely through distance online education with face-to-face practical components as detailed below. Half load options are available for students who wish to complete the theory part of the program in year 1 (mostly online), and practical part in year 2 (face to face). Acceptance into the program and placement numbers are limited by the number of available WIL placements.

Attributes giving the best chance for student success in this program: As a guideline, relevant undergraduate degrees in health sciences or education are preferable, however other degrees are also considered. Orientation and mobility specialist attributes also generally include physical dexterity and fitness (to train under blindfold, walk backwards on stairs, and be able to walk at least 5km); educational and emotional intelligence (accepting the duty of care for the physical safety of individuals with multi-disability) and flexibility for extensive travel to clients, both as a student and a graduate.

For further information please refer to our  FAQ’s  or visit the  degree page .

Practical Components

Prior to engaging in WIL, students will complete the practical components of the O&M Techniques course (VISN5521) to prepare for the work integrated learning (WIL) placement. Techniques Training (TT) equips the student to be ‘WIL ready’ and involves over five weeks of face-to-face techniques training at UNSW in Sydney. This training will involve students both being under blindfold for significant periods of time and learning to teach O&M techniques to other blindfolded students. 

Students are required to purchase mobility cane sets for the techniques training.

• Work integrated learning (WIL) (VISN5523 Part A&B):  The aim of WIL is to expose students to contemporary O&M practice and facilitate some equivalence of experience for the student, while gaining competencies. The duration of the UNSW WIL placement is dependent on meeting the required number of instructional hours and UNSW competencies.  Whilst the achievement of the required hours will be different for each student due to placement variables, we estimate this will be approximately 20 weeks of full-time work integrated learning (WIL) placement. If appropriate WIL supervision (with a Certified Orientation and Mobility Specialist) cannot be arranged in your state or region, students might need to undertake WIL placement away from their area or interstate. The cost associated with attending practical components (in particularly travel, accommodation and meeting away-from-home costs) will be met by the student. 

Pathway to Accreditation

Students will graduate with the specialised knowledge and skills required to work in Australia as an O&M Specialist.  Accreditation is required by some employers through the US based ACVREP (Academy for Certification of Vision Rehabilitation & Education Professionals). The UNSW Graduate Diploma of Orientation and Mobility meets the core domain requirements for graduates to apply for certification through ACVREP however after graduation students will need to accumulate further supervised practice hours to apply for and sit the Certified Orientation and Mobility Specialist (COMS) exam.

2024 O&M Program calendar for the compulsory techniques training dates.

Course Outlines

• VISN5511 The Visual System, Impairments & Implications (6 UoC)
• VISN5512 Sensory Processes and Movement (6 UoC)
• VISN5513 Orientation and Mobility Foundations: Disability, Diversity and Inclusion (6 UoC)
• VISN5521 Orientation and Mobility Techniques 6UoC
• VISN5522 Vision Rehabilitation (6 UoC)
• VISN5523 Orientation and Mobility in Practice A (6 UoC)
• VISN5523 Orientation and Mobility in Practice B (6 UoC)
• VISN5531 Development and Ageing: Implications for Orientation and Mobility (6UoC)

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Please  visit the scholarships page  to view available scholarship opportunities once they become available in the latter part of the year. 

Program Information session 

Hear from our panel of expert staff to guide you through the details of the Graduate Diploma of Orientation and Mobility as well as have a taster lecture to experience first-hand how this program can expand your professional horizons or inspire a career change:  https://www.youtube.com/watch?v=E9C4bxZC2dk  

The program acknowledges the extensive collaboration and support from industry stakeholders in supporting students through the program.

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Student research opportunities

Graduate students in our vision science programs are immersed in research as part of their degree requirements and to prepare them for careers in academic or industry research. With leading programs in biology, optics, imaging, and vision science, our faculty researchers work closely with students to provide the basis for advanced research training.

Dean’s Scholars Program

The Dean’s Scholars Program is a summer research training program for optometry students who have completed their first year of optometry school. The trainee, who is paid a stipend, works in a faculty lab and takes an intro to research course. The goal of the program is to provide research experiences for optometry students who are simply interested to see what ophthalmic research is like, or have an interest in an academic, or research career within optometry. While you may be taking a couple of OD classes during the summer, the Dean’s Scholar Program is very time-flexible and is easily managed by students who are well organized.

The Process:

Faculty interested in having student researchers will present a brief overview of their research at the introductory lab tour, held in the fall semester and open to any student. The tour will help you determine if the program matches your interest, previous experience, or capabilities. Then you are encouraged to approach the faculty to ask for more information and whether they can support you as a Dean’s Scholar. Only those project’s that can be started and mostly performed in the summer will be considered for the program. In addition to the actual research, Dean’s Scholar participants will take two short research related courses. At the end of the summer, Dean’s Scholars are expected to present the progress of their project either as a poster or a talk. Those who complete the summer program will be recognized on their IU transcript as Dean’s Research Scholars. Projects that are incomplete or there is a desire to extend it past the summer can continue at the discretion of the student and faculty advisor. 

A stipend of $6000, $3000 from the faculty and $3000 from IUSO, is provided. $2000 will be disbursed on June 1, July 1, and August 1.

If you have any questions about this program, please speak with the program director, Professor, Don Miller .

Undergraduate research opportunities

Qualified undergraduate students can gain valuable vision science and optometric-based research experience in any of our research labs.

Get to know our research areas and research faculty , and contact faculty members directly. Be sure to provide a brief cover statement and a CV, along with the names and contact information for three references.

For questions about formal research training through a graduate program in vision science, contact Dr. Stephen A. Burns, Associate Dean for Graduate Programs, at staburns@indiana.edu .

School of Optometry resources and social media channels

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Optometry and Vision Sciences Research

Anterior eye, clinical trials and research translation unit.

The Anterior Eye, Clinical Trials and Research Translation unit adopts an integrated approach to research in ocular disease, combining clinical, laboratory and behavioural science as a foundation for evidence-based practice to improve clinical outcomes.

• Advancing eye care for people with AMD through integrating clinical research and its translation
• An integrated approach to improving the primary clinical care of patients with early stages of AMD
• Modulation of the anterior eye inflammatory response to treat dry eye disease

Clinical Psychophysics Unit

Our research aims to better understand normal visual processing and damage due to disease.

• Development of open source tools for vision research
• Improving clinical tests for diagnosis and management of vision loss (imaging and perimetry)
• Vision in migraine
• Visual perception in migraineUnderstanding visual processing in aging and development

Corneal and Ocular Immunology Unit

The mouse and human cornea contains populations of resident immune cells such as macrophages and dendritic cells. These cells play an important role in generating innate inflammatory responses against microbial pathogens and sterile injurious stimuli.

Eye Movement Laboratory

The Eye Movement Laboratory addresses a range of problems relating to eye movement control in both clinical populations as well as in normal subjects.

• Eye movements in neurodegenerative disease
• Pupillary Indicators of Fatigue
• Saccadic Eye Movements

Imaging Retinal Cells Human Unit

Our broad research aim is to understand the fundamental workings of the living retina on the microscopic scale, and how this becomes compromised in sight-debilitating diseases such as diabetes and glaucoma.

• Functional assessment of individual photoreceptors in the human eye
• Longitudinal investigation of neurovascular dysregulation and capillary angiopathy in young people with diabetes

Learning and Teaching Laboratory

Our research is directed at identifying and implementing best practice innovative teaching strategies to enhance learning and teaching across all programs within the Department of Optometry and Vision Sciences, and externally through collaborative projects.

National Vision Research Institute

The National Vision Research Institute is dedicated to research aimed at better understanding the complexities of vision and its disorders. Our goals are preventing blindness and restoring sight.

Ocular Biomarker Laboratory

The Ocular Biomarker Laboratory is interested in ways in which we can utilise the unique attributes of the eye to inform us about cortical disease and drug development.

• Assessing novel compounds for diagnostic retinal imaging
• Developing iPad home-monitoring platforms for multiple sclerosis assessment
• In vivo physiological characterisation of Parkinson’s disease
• Using the eye as a window into Alzheimer’s disease
• Wireless electroretinography and visual evoked potentials for central nervous system drug testing

Ocular Physiology Laboratory

Our laboratory is interested in electrophysiology, imaging and developing novel methods for analysis and its application to understanding the risk factors for neurodegenerative diseases such as glaucoma.

• Developing novel ocular biomarkers for drug testing and neurodegenerative disease of the CNS
• Evaluation of vascular, glial and functional deficits in diabetic eye disease
• Investigating the role of intracranial pressure in glaucoma
• Understanding the role of blood pressure, vascular autoregulation in ageing and glaucoma
• Using our novel model of glaucoma to understand if ganglion cells can recover from injury

Optological Laboratory

The Optological Laboratory non-invasively investigates how the human eye and brain function, both in normal observers and those with eye disease.

• Analysing visual field data in macular disease
• Comparing oculomotor decision-making models for halting inappropriate actions
• Getting back on track after the unexpected happens: decision making in predictable and unpredictable environments
• The effect of intraocular pressure on retinal ganglion cell function
• The role of fixational eye movements in spatial vision
• Understanding progressive vision loss in the eye disease glaucoma

Retinal Structure and Function Laboratory

The Retinal Structure and Function Laboratory (RSFL) aims to increase our understanding of the link between structural and functional measures of damage in disease.

• A clinical test of dark adaptation for age-related macular degeneration
• Retinal structure and function in ageing and disease

Vision Optimisation Unit

The Vision Optimisation Unit aims to improve the vision of people with eye disease (particularly retinal disease), through medical vision restoration therapies, low vision aids, sensory substitution, and low vision rehabilitation

• Improving Patient Management Pathways in Age-Related Macular Degeneration
• Saving Sight Through Novel BioTech Innovations for Inherited Retinal Disease
• The Impact of Low Vision Assistive Technology on Mobility in People with Vision Impairment

Visual and Cognitive Neuroscience Laboratory

Our laboratory is interested in understanding the neural basis of visual perception, attention and memory.

• Functional microcircuitry of the primary Visual Cortex
• Neural Mechanisms of Attention
• Parallel Pathways in Vision
• Visual Attention, Reading & Dyslexia

Visual Functions Laboratory

This laboratory develops and applies behavioural and electrophysiological methods to better understand vision during development and ageing, as well as in the detection and monitoring of eye or systemic disease.

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Student theses

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Accommodation and intraocular pressure.

Supervisor: Gilmartin, B. (Supervisor) & Wolffsohn, J. S. (Supervisor)

Student thesis : Doctoral Thesis › Doctor of Philosophy

A clinical evaluation of corneal endothelial cell density in patients wearing PMMA corneal contact lenses

Student thesis : Master's Thesis › Master of Philosophy

A collection of studies on the biometry of myopic and non-myopic eyes

Supervisor: Logan, N. S. (Supervisor) & Cubbidge, R. P. (Supervisor)

A comparison between static and kinetic visual attention as a means of detecting age-related deterioration of the visual system and driving performance

Supervisor: Dunne, M. C. (Supervisor)

A comparison of computer aided learning and traditional didactic lectures for teaching clinical decision making skills to optometry undergraduates

A comparison of single vision aspheric spectacle lenses for aphakia, a comparison of two fast threshold strategies, spark and sita in threshold perimetry.

Supervisor: Heitmar, R. (Supervisor) & Cubbidge, R. (Supervisor)

Student thesis : Doctoral Thesis › Ophthalmic Doctorate

A critical evaluation of contrast susceptibility as a predictor of driving accident involvement

A longitudinal study of ocular biometry and vision-related quality of life in singapore young adults.

Supervisor: Sheppard, A. L. (Supervisor)

Ambulatory EEG monitoring in the diagnosis and treatment of epilepsy and related disorders

Supervisor: Jeavons, P. (External person) (Supervisor) & Harding, G. F. A. (External person) (Supervisor)

Analysis of variables measured in the visual screening of University of Birmingham freshmen and a critical review of visual screening methods and approach

Student thesis : Master's Thesis › Master of Science (by Research)

An analysis of progressive addition spectacles lens design by the use of interferometry

An analysis of the impact of visual impairment on nutritional intake, activities of daily living and vision related quality of life in adults with vi.

Supervisor: Bartlett Eperjesi, H. E. (Supervisor), Cooke, R. (Supervisor) & Farrow, C. (Supervisor)

An assessment of the technique and clinical application of visual evoked response measurements

An evaluation of electrodiagnostic measures of hearing, an evaluation of the emergency macular assessment clinic (emac): referral, diagnosis and treatment outcomes.

Supervisor: Naroo, S. (Supervisor) & Shah, S. (Supervisor)

Student thesis : Doctoral Thesis › Doctor of Optometry

A new algorithm for the relationship between vision and ametropia

Supervisor: Dunne, M. C. (Supervisor) & Armstrong, R. A. (Supervisor)

An investigation into the relationship between pupil and accommodation responses during near vision

Supervisor: Gilmartin, B. (Supervisor)

An investigation of reading ability and visual function with eccentric visual field

An investigation of the pressaccidic spike potential.

Supervisor: Jones, L. (External person) (Supervisor) & Harding, G. F. A. (External person) (Supervisor)

An investigation to determine the influence of illumination sources on colour discrimination in normal subjects and smokers

Supervisor: Cubbidge, R. P. (Supervisor)

An optical study of human ocular dimensions

Supervisor: Barnes, D. A. (External person) (Supervisor)

Anterior segment anomalies and effects on visual quality

Supervisor: Naroo, S. A. (Supervisor) & Eperjesi, F. (Supervisor)

Application of digital image processing techniques to the photometric testing of vehicle headlamps

Application of naïve bayesian artificial intelligence to referral refinement of chronic open angle glaucoma, application of naïve bayesian sequential analysis to primary care optometry, aspects of tear fluid composition in hydrogel contact lens wear, aspects of tonic accommodation and tonic vergence, assessment of the oculomotor response in human factor environments.

Supervisor: Wolffsohn, J. S. (Supervisor)

A study of short latency photically evoked potentials in man

A study of some indicators of corneal metabolic activity in periods of contact lens wear, a study of the effects of orally administered female hormones on the volume and composition of lacrimal fluid related to the toleration of corneal contact lenses.

Supervisor: Sabell, A. G. (External person) (Supervisor)

A study of the somatosensory evoked potential in man using brain mapping techniques

Automated assessment of visual fields and their inter-relation to evoked potentials in visual disorders.

Supervisor: Harding, G. F. A. (External person) (Supervisor)

Autonomic dysfunction and systemic oxidative stress associated with glaucomatous optic neuropathy

Supervisor: Hosking, S. L. (Supervisor)

Behavioural correlates of ocular accomodation and the autonomic nervous system

Supervisor: Wolffsohn, J. S. (Supervisor) & Gilmartin, B. (Supervisor)

Bio-adhesive polymers containing liposomes for DED treatment

Supervisor: Davies, L. N. (Supervisor) & Wolffsohn, J. S. (Supervisor)

Biomechanical aspects of the anterior segment in human myopia

Biometric and physiological factors in human ocular perfusion, blood vessel diameter in glaucoma, cataract, macular characteristics and assessing lens opacities, changes in ocular refraction in the strabismic child: as longitudinal study, changes in tear film metrics and ocular signs induced by different types of refractive correction in an aging population.

Supervisor: Davies, L. N. (Supervisor), Wolffsohn, J. S. (Supervisor) & García-Lázaro, S. (External person) (Supervisor)

Characteristics of visual function in Asperger’s syndrome and the autism spectrum

Supervisor: Cubbidge, R. P. (Supervisor), Hosking, S. L. (Supervisor) & Seri, S. (Supervisor)

Clinical applications of the visual evoked potential: a comparative study of diffuse flash and pattern reversal stimulation

Clinical studies of spatial and temporal aspects of vision: an investigation using psychophysical and electrophysiological techniques.

Supervisor: Drasdo, N. (External person) (Supervisor)

Computer modelling of the actions of extraocular muscles

Contact lenses and sport.

Supervisor: Naroo, S. A. (Supervisor) & Wolffsohn, J. S. (Supervisor)

Contiguous visual and brain stem auditory evoked potential recordings of premature infants

Contrast matching and discrimation in human vision.

Supervisor: Rovamo, J. (External person) (Supervisor)

50 Thesis Topics in Ophthalmology to Know What to Write About

Table of Contents

Ophthalmology Thesis Topics: What Should They Be?

Thesis topics in ophthalmology should represent solid research in the sphere on the basis of strong evidence. While writing a thesis, one should pay attention to the statistical measures in the field to address the methods and techniques of solving difficult medical tasks. Thesis topics in ophthalmology are significant for the examination of the urgent topics on eye diseases and the discovery of the means of treating the eye conditions.

Ophthalmologists have long been engaged in eye treatment, the study of physiology, but in recent years, science has made a huge leap forward. Today, these doctors create new methods of treatment, conduct scientific activities, trying to find the causes of the development of various diseases, work with congenital and acquired pathologies.

Ophthalmology Research Data to Think Over

If we talk only about statistics in America , then 24, 4 million Americans suffer from cataracts. By the age of 75, this figure reaches half the total population of America of this age. Glaucoma, in turn, affects 2.7 million Americans over 40 years of age.

These figures determine the demand for ophthalmologists in the labor market and the popularity of training in the specialty “Ophthalmology”. Innovative techniques, modern scientific knowledge, and equipment today make it possible to cure eye diseases, which 10 or 15 years ago deprived patients of sight forever.

That is why medical students are involved in scientific activities starting from college, and the successful writing of a dissertation is almost a guarantee of high professionalism of the graduate and his readiness to help people maintain the ability to see the world. Below we have collected 50 topics of dissertations in ophthalmology. Choose the most interesting to prove that you have the right to call yourself a doctor and treat people.

To begin with, due to the negative impact of computers and laptops, the majority of individuals experience eye pain and dry eye condition. This might be an important topic for discussion since it is estimated that millions of adults suffer from the dry eye. The controversies in ophthalmology have arisen over a long time concerning the etiology of dry eye and experience of pain. The evidence from other fields shows that alterations in the central nervous system exacerbate the irritative symptoms and eye pain. Sometimes, the patient can complain about chronic pain syndrome that is characterized by systemic pain.

Dry eye disease occurs in 5% to 35% of the world population and is more present in females. The condition has severe consequences for life quality negatively influencing visual activity, productivity at work, social interaction, and physical functioning. The sources reveal that individuals with dry eyes of the moderate and severe degree have similar either social or psychological life as people experiencing angina of the same degree or those who made hospital dialysis. The dry eye condition is connected with the disorder of the tear film, meibomian glands, violation of normal ocular surface, and inflammation of the eye surface. The disease is accompanied by the huge discomfort, disturbance of tear film, and visual difficulties that might lead to the damage of the ocular surface. Patients suffering from dry eye disease have problems with focus because of the tear film osmolarity and ocular surface inflammation.

Corneal sensation remaining intact is essential to keep the healthy ocular surface as well as quality and quantity of tears because corneal nerves have the direct trophic impact on maintaining the corneal epithelium. Corneal confocal microscopy (CCM) might be used to reflect the cornea involving the sub-basal nerve layer in people with dry eye disease. As a matter of fact, the condition can be triggered by the majority of mechanisms that result in the ocular irritation; however, it is still not understood what is the cause of dry eyes when the tears are normally produced and the ocular surface is moist enough.

To conclude, the discordant dry eye appears because of the tear production discordance and ocular surface staining. The processes in the central nervous system are interchangeably connected with the severe symptoms of eye strain and ocular surface damage. Further research should be done to relieve the symptoms and find the adequate treatment of the disease.

50 Ophthalmology Dissertation Topics to Choose From

Feel free to check the following list of topics.

• Surgical Treatment of Exophoria Complicated by Horizontal V-Syndrome;
• Possibilities of Detecting Early Disturbances in Eye Hydrodynamics in Patients with Cataracts and Ocular Manifestations of Pseudoexfoliation Syndrome;
• Ultrasound Biomicroscopy in the Diagnosis of Pathology of the Extreme Periphery of the Fundus;
• Experimental Clinical Rationale for the Use of Nd: Yag Laser with a Wavelength of 1.44 Microns in the Technology of Anterior Capsulorhexis and Remote Hemostasis;
• Medico-Technological System of Surgical Treatment of Progressive Keratectasia of Various Origins;
• Subthreshold Micropulse Laser Treatment with a Wavelength of 577 Nm in the Treatment of Central Serous Chorioretinopathy;
• The Clinical and Experimental Rationale for the Combined Use of Neodymium Ion 1.44 Microns and Helium-Neon 0.63 Microns Lasers in Cataract Surgery;
• Yag-Laser Activation of Trabeculae in the Treatment of Patients with Primary Open-Angle Glaucoma;
• The Study of the Effectiveness of Micropulse Laser Irradiation with a Wavelength of 577 Nm in Macular Edema After Surgical Removal of Idiopathic Epiretinal Membrane;
• The Clinical and Experimental Rationale for Optimized Uv-Crosslinking Technology in the Treatment of Keratoconus;
• Clinical And Laboratory Substantiation of the Use of Orthokeratology Lenses in Progressive Myopia in Children;
• Optimization of Surgical Treatment of Retinal Vein Thrombosis Outcomes;
• The Results of Surgical Correction of High Myopia with Anterior Chamber Phakic Intraocular Lenses;
• The System of Treatment and Rehabilitation Activities in Patients with Paralytic (Paretic) Strabismus;
• Surgical Treatment of Keratectasia of Various Origins by the Intrastromal Keratoplasty Method with Polymeric Corneal Segments;
• Comparison of Spectral Optical Coherence Tomography and Confocal Scanning Laser Ophthalmoscopy in the Diagnosis of Primary Glaucoma;
• Clinical and Functional Results of Surgical Treatment of Rhegmatogenous Retinal Detachments Using the Method of Peri-Basal Vitrectomy;
• The Modern System of Diagnostics, Treatment, and Organization of High-Tech Ophthalmic Care for Children with Active Stages of Retinopathy of Prematurity;
• Limbal Co-Transplantation in the Prevention of Rejection of Donor Corneas in High-Risk Keratoplasty;
• Vascular Disorders in the Anterior Part of the Eye at Different Stages of Pseudoexfoliation Syndrome;
• Induction of Posterior Vitreous Detachment in the Surgical Treatment of Retinal Detachment;
• Combined Phacoemulsification Method in Patients with Operated Glaucoma;
• Features of the Quality of Life of Patients with Cataract and Glaucoma Before and After Surgical Treatment;
• Ophthalmologic Diagnostics and Tactics of Treatment of Cranio-Orbital Injuries in the Acute Period of Traumatic Brain Injury;
• Features of Pupillary Reactions and Regional Hemodynamics of the Eye in Patients with Diabetes Mellitus with Different Levels of Glycemia;
• Prevention and Treatment of Corneal Lesions in Endocrine Ophthalmopathy;
• Antibacterial Drugs in the Prevention of Complications of Cataract Phacoemulsification;
• Possibilities for Stimulating the Secretion of Tears in Patients with Hypolacrimia in the “Dry” Eye Syndrome;
• Diagnosis and Treatment of Actinomycotic and Mycotic Diseases of the Lacrimal Ducts;
• Study of the Clinical Efficacy of Diaphragm Glasses;
• The Study of Sclera Rigidity In Healthy and Glaucomatous Eyes;
• Clinical and Instrumental Diagnosis of Malignant Tumors of the Orbit;
• Ophthalmotonus Biorhythms in Health and Glaucoma;
• Clinical And Laboratory Diagnosis of Early Stages of Keratoconus;
• The Clinical and Functional Rationale for the Tactics of Surgical Treatment with a Combination of Retinal Detachment with Lens Opacities;
• Combined Surgical Treatment of Retinal Detachment in the Advanced Stage of Proliferative Diabetic Retinopathy;
• Mathematical, Experimental and Clinical Rationale for the Prevention and Correction of Corneal Astigmatism and Capsular Bag Pathology in Cataract Surgery;
• The Method of Combined Treatment of Progressive Myopia;
• Modification of Sinusotomy in the Treatment of Primary Open-Angle Glaucoma;
• Optimization of Diagnosis and Surgical Treatment of Involutional Entropion of the Lower Eyelid;
• Peripheral Vortical Dystrophies and Retinal Detachment in Pregnant Women: Diagnosis, Treatment, Choice of Method of Childbirth;
• Indices of Intraocular Pressure of a Newborn Child Due to the Morphological Features of the Drainage System of the Eye at Different Periods of Gestation;
• The Use of Silicone-Hydrogel Contact Lenses in the Treatment of Ulcerative Keratitis;
• Prolonged Pharmacotherapy of Glaucomatous Optic Neuropathy;
• Modern Aspects of Viscosurgery in Ophthalmology;
• Current Possibilities for the Prevention and Treatment of a Blepharo Conjunctival Form of Dry Eye Syndrome of Demodectic Etiology;
• An Experimental Study of the Effectiveness of Cell Transplantation in Post-Traumatic Pathology of the Retina;
• Vitreoretinal Changes in Case of Eye Injury by Splintering;
• Diagnosis and Treatment of Optic Nerve Hypoplasia in Children;
• Ocular Manifestations of Antiphospholipid Syndrome.

10 Resources to Find More Information on Ophthalmology Topics

Here are some scientific journals websites you may look through.

• American Journal of Ophthalmology Case Reports
• Clinical Ophthalmology
• Current Trends in Ophthalmology
• Digital Journal of Ophthalmology
• International Journal of Keratoconus and Ectatic Corneal Diseases
• International Journal of Ophthalmology & Visual Science
• IP International Journal of Ocular Oncology and Oculoplasty
• Journal of Current Glaucoma Practice
• Medical Hypothesis, Discovery, and Innovation in Ophthalmology
• Neuro-Ophthalmology & Visual Neuroscience

5 References to Write an Ophthalmology Thesis

• Bron, A. J., Tomlinson, A., Foulks, G. N., Pepose, J. S., Baudouin, C., Geerling, G., … & Lemp, M. A. (2014). Rethinking dry eye disease: a perspective on clinical implications. The ocular surface, 12(2), S1-S31.
• Dry eye disease: risk factors and selecting treatment. (2015). The Pharmaceutical Journal. http://dx.doi.org/10.1211/pj.2015.20069420
• Shtein, R. M., Harper, D. E., Pallazola, V., Harte, S. E., Hussain, M., Sugar, A & Clauw, D. J. (2016). Discordant dry eye disease (an American Ophthalmological Society thesis). Transactions of the American Ophthalmological Society, 114.
• Sullivan, B. D., Crews, L. A., Messmer, E. M., Foulks, G. N., Nichols, K. K., Baenninger, P., … & Lemp, M. A. (2014). Correlations between commonly used objective signs and symptoms for the diagnosis of dry eye disease: clinical implications. Acta ophthalmologica, 92(2), 161-166.
• Yun, C., Kang, S., Kim, H., & Song, J. (2012). Prevalence of Dry Eye Disease among University Students. Journal Of The Korean Ophthalmological Society, 53(4), 505. http://dx.doi.org/10.3341/jkos.2012.53.4.505

Hopefully, you will find our article useful and be able to write the best ophthalmology dissertation ever! Despite choosing a topic, the thesis writing process takes a lot of time to take the other steps – brainstorming, research, note-taking, outlining, structuring, drafting, writing itself, formatting, proofreading, etc. If you want to save you time or nerves, you know what to do. Right? DoMyPapers.com is 24/7 open to you.

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Optometry students’ perspective on optometry in suburban Western India: A qualitative study

Dinesh venugopal.

a Optometry Division, Allied Health Science Course, Goa Medical College and Hospital, Bambolim 403202, Goa, India

b School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Qld., Australia

Suchana Shirodker

Rashmi kanojiya.

c Laxmi College of Optometry, Panvel 410206, Navi Mumbai, Maharastra, India

d ITM Institute of Health Sciences, New Panvel 410206, Navi Mumbai, Maharastra, India

Rakesh Kaushal

Optometry has been an established profession in India for 60 years. Despite this, students who choose this course may have misconceptions and unrealistic expectations about the profession. The goal of this study is to understand the perceptions about optometry among optometry students, prior to and during their studies.

A snap-shot narrative qualitative study using a semi-structured open-ended questionnaire was designed to understand the perception of optometry. Optometry students and educators from three suburban colleges were invited to participate. Forty-one participants took part in 24 in-depth interviews and 5 focus groups; of those 32 were undergraduate optometry students and 9 were optometry educators. Interviews and focus groups were audio-recorded, transcribed, coded, and analyzed.

Three major themes emerged: retrospective perception of optometry, current perception and strategies to improve awareness level. All the participants mentioned that there was a considerable lack of awareness about optometry in society. None of the students stated that they chose optometry as their first choice of professional education. Most students expressed that they were provided with ample exposure during the curriculum to understand the scope of optometry. Various strategies were recommended to improve the level of awareness of optometry.

Conclusions

The current study highlights the lack of awareness and knowledge of optometry among the students while enrolling in the course. Knowledge about the scope of optometry practice among optometry students improved after extensive education and clinical exposure. Improving the awareness level of the profession will improve the quality of students entering the profession.

Introduction

Optometric education has been established in India six decades ago, starting initially with a 2-year course, and then progressing to a 4-year graduation program. 1 , 2 , 3 In India, optometrists are trained in an extensive range of eye care services such as comprehensive eye examination, ocular diagnostic service, contact lenses and spectacle dispensing, vision therapy and visual rehabilitation. 4 In terms of the World Council of Optometry (WCO), Indian optometrists are highly skilled and competent. 5 They practice in multiple settings such as hospital/clinic-based practice, academics, optical retail, research, administration, marketing, and independent private practice. 6

According to the India Vision Institute report, there were approximately 49,000 practicing optometrists, and 164 institutions providing optometry education in India. 7 WCO reports that there are about 358 teaching institutes and 250,000 optometrists, globally. 5 Overall, these numbers indicate that India contributes about 19.6% of the optometrists to the world. However, the proportion might be overestimated because only 70 out of 358 known optometry organizations across the globe work in collaboration with WCO. 5 , 7

Despite being a well-established profession, optometric practice lacks acceptance in many countries. 8 Considering this scenario, we conducted a pilot study to explore the outlook and awareness of optometry among 9 optometry students and 2 optometry educators. Our pilot findings suggested that prior to commencing their studies, optometry students have misconceptions, false expectations and insufficient information about their profession. 9 A similar situation prevailed in many other developing countries, such as Mozambique, Saudi Arabia, and Ghana. 10 , 11 , 12 Eye care services in India are scattered, without formal regulation. There are no specific practice guidelines, licenses or registration for eye care professionals such as optometrists, refractionists, orthoptists, ophthalmic assistants, and ophthalmic technicians. 13 All these professions perform comprehensive eye examination and dispense spectacles and contact lenses without any specific regulatory structure, 13 , 14 whereas in developed countries the governments and/or law regulates the optometry education and provides practice guidelines. 15 , 16 , 17 , 18 Optometrists in developed countries such as the United Kingdom, Spain, Ireland, United States, Canada, Australia, and European countries play an integral role in eye care practice. 20 , 21 , 22 , 23 , 24 , 25 Other professions such as physiotherapy, occupational therapy, and speech therapy also lack awareness but, professions such as medicine and dentistry are well-accepted among the people in India. 19

There have been no previous studies on the perception of optometry practice or optometry education in India. With respect to other nations, India is now above the Median Development Index, with a developing middle class. So there should be increasing popularity about the role of optometrists in the country, but to the best of our knowledge, there is no current information about this. While self-efficacy and efforts are both indicators of academic success, less is known about the effects of prior career knowledge and attitudes. 10 , 26 Students who choose their courses with a definite career plan are more likely to have academic success 27 and students who do not actively choose their courses are less likely to finish their degrees. 28 Likewise, students who were satisfied with their chosen course were more likely to succeed in their respective careers. 29 Given the importance of prior knowledge of the profession to academic success, value of course satisfaction and lack of information about optometry students’ attitudes; a qualitative study was designed to understand the retrospective perception (i.e., the perception prior to entering the course) and current perception about optometry among optometry students, via focus group discussions and interviews.

A snap-shot narrative qualitative study was conducted using in-depth interviews and focus groups. 30 The rationale was to ensure a comprehensive understanding of the retrospective perception, present knowledge and future scopes of the profession. To obtain a broad range of perspectives, optometry students and educators (optometrist) were recruited from 1) Laxmi College of Optometry, 2) ITM Institute of Health Sciences (ITMIHS), and 3) Allied Health Science - Goa Medical College and Hospital. All the three colleges offered a four-year optometry undergraduate program and were located in suburban regions of Western India. The study was conducted in adherence to the tenets of the Declaration of Helsinki and was approved by the Institutional Ethics Committee of Goa.

Interview guide

A semi-structured open-ended questionnaire with probes was developed based on group discussions with optometrists engaged in student recruitment procedures and first-year undergraduate students. Questions were directed on the retrospective knowledge about optometry, present perception of the profession, future perspectives, and generalized view on awareness of optometry in the community. The interview guide was reassessed and modified after each session (interview or focus group). However, the aim of the study was not altered at any point during the study period.

The interview guide used for optometry students were as follows; 1) When did you come to know about the optometry profession?, 2) How did you come to know about optometry?, 3) What information have you heard about optometry course or optometrist prior to course enrollment? (a. Course duration, b. Subjects involved in optometry, c. Practice pattern), 4) What was the perception of optometry among your family members or relatives?, 5) After enrollment into the optometry course, what is your perception about the profession and how it is different from what you already knew?, 6) What additional information did you come across during your course work?, 7) What is the role of an optometrist in eye care services?, 8) What are the future scopes in optometry?, 9) What is your future plan in the optometry profession after graduation?, 10) What is your generalized opinion on awareness of optometry in the community and why?, 11) What is the level of awareness of optometry among your family members or relatives?, 12) What is the overall level of awareness of optometry in India?, 13) What are the factors influencing the current level of awareness? (a. Eye hospital, b. Optical, c. Government policy, d. NGO initiative, e. Community outreach programs), and 14) How can we create more awareness in the community?. For optometry educators, the questionnaire was rephrased to refer to students’ in the third person, without altering the meaning of questions. For instance, question 1 was rephrased as ‘Based on your experience, when do optometry students come to know about the profession in general?’. Likewise, the rest of the 13 questions were rephrased and used as an interview guide for the educators.

Preparation for the interviews and focus groups

All the investigators were trained in the interview methods. English was chosen as the medium of discussion for the interviews and focus groups. A calm environment was identified in each institute to facilitate audio recording. The participants were divided into students and educators. A single moderator (DV) and a note-taker (BL) who had academic teaching experience moderated the sessions of educators. For the student participants, three moderators (SS, RK, and RKL) at three different venues and a note-taker (DV) moderated the sessions. The role of the note-taker was to record the non-verbal cues of all the participants and to assist the moderators in probing questions from the interview guide. All the interviews and focus groups were planned and carried out on separate days, which facilitated the author (DV) to transcribe the interviews and rephrase the questions in accordance with the response of the previous interview. Theoretical data saturation (redundancy of information) was considered as the endpoint of the study.

Data collection

The inclusion criteria for undergraduate optometry students were that they lived within 50 km of radius from the optometry college and belonged to the suburban locality. In the second group, optometry educators with academic teaching experience of at least one year and involved in optometry course recruitment process were included. Overall, the colleges had 262 students, out of which 117 students fulfilled the inclusion criteria. Using simple randomization 53 students were invited, out of which about 90% (48/53) conveyed their willingness to participate. Among the optometry educators, a total of 10 (out of 16) educators had been involved in the recruitment process and therefore fulfilled the inclusion criteria, out of which 9 were willing to participate. All the 9 educators were invited to participate in the study. The in-depth interviews were one-on-one discussion, and each focus group had 4–5 participants. At the start of each session, the participant(s) were welcomed, and refreshments were provided. The interaction between the moderator and participant(s) began with a general discussion on weather and daily news to create a friendly atmosphere. The participant(s) were then transferred to the interview site, and the agenda of the study was explained. Written informed consent was obtained from all the participants.

The discussion began with the narration of open-ended questions (one at a time), and the participants were asked to respond to the questions in English. During the interviews and focus groups, the above-mentioned interview guide was used as a reference to direct the moderator towards the study aim. Moreover, if a participant gave an uncertain or unclear statement, their reasoning was requested: such as ‘why?’ or ‘what is your opinion on it’ or ‘how?’ or ‘when?’ or ‘anything else?’. A similar approach was administered for all the questions from the interview guide. On the other hand, if the participant did not respond to all the information on a specific question, probes were given. A scenario from the present study is given as an example: “What information have you heard about optometry course before enrollment?” If the participant had not mentioned anything about the ‘course curriculum’, then “What have you heard about the course structure and subjects undertaken in the course?”. A parallel approach was followed in focus groups; also the participants were permitted to interact with each other to derive new categories. At the end of each session, the moderator summarized all the information stated by the participant. Any terminology expressed in the local language (Hindi, Konkani, and Marathi) was translated into English by the participants. Likewise, if any non-verbal cues were used during the session, the participant(s) were requested to express verbally. The data collection was concluded when no additional insights were obtained in the last 3 sessions.

Study participants

After, 24 in-depth interviews and 5 focus groups in two groups of 41 participants; data saturation was observed. Thirty-two undergraduate optometry students participated in 20 interviews and three focus groups (four participants in each) in group 1, among which 6 students belonged in the first-year, 7 in the second-year, 11 in the third-year and remaining 8 were optometry interns. None of the participants from the student group took part in both the interviews and focus groups. Four in-depth interviews and two focus groups (4 in first and 5 in second) were carried out among nine educators. Four tutors participated in interviews as well as focus groups.

Data analysis

The audiotaped in-depth interviews and focus groups were transcribed into verbatim by the moderators who conducted the interview. Each transcript was descriptively coded, and categorized by a single moderator (DV). Generalized data coding and analysis were carried out for all transcribed interviews and focus groups irrespective of the study group using NVivo 12 software (NVivo qualitative data analysis software; QSR International Pty Ltd. Version 12.0, 2018). The software helped organize and retrieve text linked by familiar texts. Qualitative content analysis was performed to compare the responses between two groups and the level of course completion.

The 32 undergraduate optometry students who took part had a mean age of 19.36 ± 1.28 (SD) years, of which 21 participants were female. The 9 optometry educators who participated had a mean age of 30.5 ± 2.02 (SD) years and had a mean level of teaching experience of 3.83 ± 2.25 (SD) years respectively, of these educators 5 were female. The categories obtained from both groups were similar, as the study aimed to address the perception of the student community. Three major themes that emerged out of the qualitative analysis are as follows.

Theme 1: Retrospective perception of optometry

The subthemes obtained under this theme were; the outlook of optometry in society, the reason to undertake the course, and expectation(s) from the course.

• a The outlook of optometry in society

All the participants stated that there was a considerable lack of awareness about optometry in the community. Most students had come to know about the program after completing their higher secondary education. Several optometry students mentioned that their family members and relatives were not familiar with the profession when they enrolled and also mistakenly understood that the candidate was pursuing ophthalmology training. The educators suggested that lack of awareness about optometry is the most critical reason why higher secondary students with good academic merits do not take up the optometry profession.

“Most of the people in India have never heard about optometry or optometrist.” (Interview 03: Educator) “There is no awareness of optometry in society. Even when I informed my relatives that I am pursuing an optometry course; they asked, ‘What is optometry exactly?’ Then I had to explain to them about the course and the role of an optometrist in society.” (FGD 01; P26: Student)

Some participants suggested that people from the urban community were quite aware of optometrists and their role than the rural and suburban communities. Many participants stated that their institute played an active role in providing optometry services in the locality, which in turn improved the awareness for optometry.

• a The reasons to undertake the course

Students’ response

Many optometry students stated that they wanted to pursue medicine, and they did not choose optometry as their first career option. Apart from medicine, students were also interested in pursuing engineering, dentistry, microbiology, life sciences, humanity, and nursing. None of the students reported that optometry was their first choice for professional education. However, the primary purpose spelled out for choosing optometry was that ‘optometry is related to eye care service’, so they could serve their community. Reported evidence of job opportunities and community eye services were also expressed as the major reasons for choosing the profession. Participants with a family optical background stated that they wished to study general medicine, but eventually due to insufficient grades in higher secondary education they had to join optometry and support their family business. Family members, private professional counselors, seminars on career opportunities, eye examination or community eye screening were the sources of information for optometry in the present study.

“I wanted to pursue Medicine, but I couldn’t meet the eligibility criteria. I was keen on providing community service, so I started looking for other career options in health care. I came across the optometry program; I felt optometry would be an ideal career where I can serve the rural community.” (Interview 03: Student) “While preparing for competitive examinations for health-care, I went through different courses that were available in my state (locality). That was the first time I heard that there is a branch called optometry that deals with eye care.” (Interview 17: Student) “I read online that optometrists had very high job satisfaction in many countries compared to other health-care professions; so I opted for optometry.” (Interview 18: Student)

Educators’ response

Optometry educators also reported similar observations during the undergraduate student recruitment process. Moreover, they felt that a considerable proportion of uptake of optometry education occurred among students with a family background in the optical industry. Some educators specified that students who were eager to pursue other health-care professions showed less interest in optometry education and withdrew from the course midway.

“Some students were pursuing optometry because they required optometry skills and graduation certificate to carry over their family business (i.e. optical industry).” (Interview 02: Educator) “Few students discontinue optometry course if they get into medicine or dental education.” (FGD 05; P39: educator)

• a Expectation(s) from the course

All students recalled that they had limited information about optometry when they enrolled in the course. A majority of undergraduates thought, at the start of their studies, that the profession dealt with ‘spectacle dispensing’ only. In addition, some students also believed that optometrists would have to work alongside ophthalmologists, in a similar way to ophthalmic assistants. Only a few students perceived that after graduation, they would be able to perform independent eye examination to rule out refractive error and other ocular conditions. Most of the students expressed that they had better knowledge about the coursework of medicine, engineering, dentistry, physiotherapy, and nursing compared to their knowledge of optometry.

“I knew that optometry is a profession related to the eyes. I also had a thought that it is similar to an ophthalmologist except providing surgical management and drug administration.” (Interview 21: Student) “Before entering the course, I thought an optometrist had to work in lens manufacturing units, and optical sales after completion of the course.” (Interview 7: Student)

According to the educators, first-year optometry students had inadequate knowledge about the coursework, curriculum, structure and future scopes. Likewise, some students reported that they did not have substantial information about the subjects in the syllabus and scope during the admission process. None of the students had heard about multidisciplinary practice patterns of optometry prior to the commencement of their course.

Theme 2: Current perception of optometry

The subthemes acquired in this theme were; understanding the role of an optometrist and the future scope of optometry.

• a Understanding the role of an optometrist

After enrolling in the course, all students stated that optometry is the primary eye care profession. Students who had exposure to patient care agreed that their expectations towards the profession were adequate. Patient care helped them to understand the roles and responsibilities of an optometrist in eye care services. A majority of the students said that they could practice in various specialties of vision care after graduation. All interns mentioned that they could involve themselves in school vision screening and community eye screening programs in the future. Most educators mentioned that they guide optometry students in the career decision-making process during the coursework.

“After completing the coursework of specialty subjects such as contact lenses, binocular vision, and low vision in the third year; I am quite confident that the optometry profession has plenty of scopes.” (Interview 15: Student)

• a The future scope of optometry

Almost every student mentioned that optometrists can dispense spectacles, contact lenses, work in marketing sectors, hospital set-ups and academics. However, only a few students expressed that optometrist could practice independently in sports vision, pediatric optometry, industrial vision care (i.e., occupational optometrist), manufacturing units of contact lenses and spectacles, and ocular prosthetics. Moreover, the senior-level students expressed that they would practice contact lens dispensing, provide visual rehabilitation services, and vision therapy services. While comparing the responses across the levels of course completion, the third-year students and optometry interns had a better understanding of the career opportunities and practice patterns compared to the first and the second-year students. Similarly, the range of clinical investigations stated by the senior students was higher in number than the entry-level students. Most students claimed that they would pursue higher education in different specialties of optometry. A few students were planning on establishing an independent optometry practice soon after graduation. All educators felt that students’ understanding of the scope and practice patterns had improved as the course progressed.

“Our college organizes yearly school screening programs at rural schools where we conduct vision assessment of the students and prescribe glasses. This experience has inspired me a lot, so I am considering to concentrate on pediatric optometry.” (Interview 11: Student)

Theme 3: Strategies to improve awareness level

The first two themes highlighted the lack of awareness of optometry in India, which led to the development of this theme. Two subthemes were derived; the role of media and public health awareness.

a. Role of media

All participants mentioned that the media would play an integral role in creating awareness about optometry. They suggested basic strategies such as advertisements in newspapers, television, radio broadcast, and social networks. Most of the students specified that creating awareness on social media such as Facebook, Instagram, and Twitter would improve awareness among their friends and followers.

“Media is an influential source for publicity these days; we can advertise on radio, newspapers, and television channels about optometry courses and clinics. We have thousands of friends at the social media platform, which makes it the best option to promote optometry.” (FGD 02; P28: Student)

b. Public awareness programs

Several participants felt that public awareness programs about optometry should be carried out in various parts of the country. Likewise, they also revealed that optometry practitioners should participate in discussions at public forums to enhance eye care accessibility. Many educators articulated that eye screening camps and rallies on eye health could also improve the awareness of the profession. The participants believed that adding information about the optometry course to career awareness programs for school students would create more impact on the younger generation. Most educators claimed that if optometry graduates set up optometry clinics to promote the profession and work for the underprivileged in rural regions, the awareness level of optometry will improve significantly. Few participants also mentioned the need for the legislative body in the country to moderate the practice guidelines of optometrist is essential like physicians and dentists.

“I came to know about optometry from an eye screening camp conducted near my residence. There were hundreds of people being screened and referred to eye hospital, and some were given free spectacles too. So, organizing multiple camps in the community will also create awareness about the role of an optometrist.” (FGD 03; P31: Student) “I feel our graduates should initiate more of independent practice to improve the awareness level of optometry, rather than working in eye hospitals or optical chains. Also, we (optometrists) need the support of a national regulatory body; like the Medical Council of India and Dental Council of India to support physicians and dentists respectively.” (Interview 02: Educator) “We organize public awareness programs and vision screening programs to create awareness about optometry.” (FGD 05; P40: Educator)

Our findings showed that, prior to entering the course, the awareness and knowledge about the optometry profession were limited among optometry students. A majority of students had heard about health-care professional courses like medicine, dentistry, and nursing during their schooling but not optometry. Moreover, most student participants in this study never intended to choose optometry as a profession in the first place. The current study results highlighted that students with good academic merits prefer medicine or other professions initially, and settle to optometry profession when failed to procure their desired profession.

The time point at which the students learn about the role of a profession is crucial. The student participants acquired basic knowledge about optometry course at the age of 17.6 (±1.2) years, which was also the time they gathered information about the career options in the health-care. Literature suggests early-to-mid adolescence is the ideal time for career exploration. 31 However, the students in this study had never heard about optometry until late adolescence, and the opinion was also backed by optometry educators. Many students perceived optometrists as spectacle dispensers or lens manufacturers when they heard about the profession for the first time. The students also reported that their family members, relatives, and peers did not perceive the profession at par with other health-care professions prior to commencement of the course. Even in most European countries, optometrists were perceived as opticians for the initial five decades. 20 Our findings also suggested that a similar situation prevails in India currently (60 years after the introduction of optometry 1 , 2 , 3 ). In addition, few studies have indicated a lack of awareness about the optometry profession in developing nations such as Mozambique, Ghana and Saudi Arabia. 10 , 11 , 12 , 32 , 33 Overall, the reason behind this lack of knowledge and awareness about optometry in these countries is not known.

Our study also showed that prior to entry, students were more aware of medicine, dentistry, and nursing compared to optometry. The roles of other professions such as physiotherapy, occupational therapy, and speech therapy are, like optometry, relatively unknown in India. 19 However, in contrast, the roles of optometry are well-understood by college students of the United States. 34 A reason for this finding could be the existence of a large number of optometrists in the United States, and there is a high probability that the participants’ encounter the profession at some point in time. The national and state regulatory bodies moderating US optometry practice might also have played a major role in enhancing the reputation of the profession. 34 Nevertheless, our results suggested that vision care services being provided in the community might contribute to the existing awareness of optometry. This agrees with other studies, which also suggest that the role of eye care hospitals and community outreach programs remains vital in generating awareness about optometry in young people and their families. 35 , 36 In addition, career counselors and family members were the source of information about optometry in this study. Literature suggests that parents and school teachers commonly influence school students in career decisions making. 37 Surprisingly, none of the student participants in the present study stated that their school teachers, or school counseling professionals, mentioned or discussed optometry. This indicates that there could be a considerable lack of awareness about optometry in school teachers, career counselors, and society. In the current study, the desire to help the community, support family business and job opportunities were mentioned as factors for opting optometry. Similar findings were also reported in the literature. 38 , 39

The perception of optometry students about their career changed after appropriate academic and clinical exposure to eye care. The students also highlighted that their family members, relatives, and peers viewed the profession positively after they enrolled in the course compared to their previous understanding. After entering the course, the students came across various aspects of optometry coursework which lead them to gain knowledge about future scopes and practice patterns in optometry. To the best of our knowledge, there are no studies that reported the changes in perception of optometry among the students pursuing the profession. A study by Thite et al. 6 reported that the Indian optometrists were involved in a range of services at eye hospitals, optical outlets, and community outreach programs. These findings are similar to our results, however, the retrospective perception of optometry showed conflicting responses which indicate a lack of initial knowledge about optometry practice. In addition, senior optometry students had a better understanding and knowledge of the career opportunities, range of vision care services and scope of practice, compared to their juniors. This suggests that optometry students need sufficient exposure and guidance to various eye care services during the curriculum to understand the broader perspective of optometry. Similarly, the literature also suggests that the knowledge about the range of practice patterns and the importance of multidisciplinary approach was higher among senior students and optometrists with higher academic qualifications, indicating the importance of more exposure. 6 , 40 These findings emphasize that the quality of education and optometry qualification are crucial in understanding the roles of the profession. In addition, De Souza et al. 4 and Rao 41 discussed the need for extensive training to deliver a successful eye care service in India. Thus, the standards of optometry education and the quality of eye care services may depend on the framework of the academic curriculum pursued by the students. Currently, there is no standard curriculum followed by the optometry colleges in India, and developing such a curriculum may improve the profile of the profession.

Overall, the results of the current study highlight the urgent need to create awareness about optometry in suburban India. Assessing and generating awareness about optometry prior to course enrollment will not only improve the intake of meritorious students, but also enhance academic performance, 10 , 27 , 42 professional success, 29 and future job satisfaction. 43 A study by Grembowski et al. 44 illustrated a positive association between job satisfaction and quality of health care service provided. Thus, improving the current perception of students would also result in delivering a better quality eye care service to the community. Several innovative approaches were suggested by the participants to improve public awareness and knowledge about the optometry profession in the present study. Participants suggested that community activities could be used as a platform to improve the awareness level of the profession. Advertisements were also one of the strategies recommended to improve awareness about optometry. A similar approach was suggested by Moser and Reed to improve public awareness and to ensure an advantageous optometry practice. 45 Literature suggests several developing countries have a lack of knowledge about eye care service and optometrist in their community. 10 , 11 , 12 , 32 , 33 The strategies identified in our study could be implemented in these countries where awareness about optometry among career seeking students is minimal. Apart from awareness of the optometry profession, the participants also reported that these strategies will create awareness about eye health in society. Similar strategies were recommended to improve eye health in the previous studies. 4 , 45 The current study highlights that several false assumptions might prevail about optometry among the student community. These misconceptions about the profession might diminish significantly if the proportion of independent practice increases resulting in general-public encountering the profession in large numbers and building awareness in the country. A study in the United States reported that the high proportion of practicing optometrists influenced the exposure to the profession among college entering students. 34 However, the proportion of independent optometry practice in India was reported only 22%. 6

Optometry educators emphasized the need for a national legislative body for independent optometry practice in the current study. This expectation is customary because of the existence of Medical Council of India and Dental Council of India which allows physicians and dentists to practice independently. Furthermore, there are different professionals in eye care such as optometrists, refractionists, orthoptists, ophthalmic assistants, and ophthalmic technicians who provide refractive services. 13 Whereas the role of eye care practice in developed countries are well-defined, this might be due to the presence of regulatory bodies in their nations, that maintains the standards of the services by stratifying the responsibilities of eye care practitioners. 20 , 21 , 22 , 23 , 24 , 25 At present, India is planning to establish a legislative and regulatory body for standardizing optometry education and moderating the practice guidelines of an optometrist in the country as suggested by the WCO. 5 , 46 , 47 Though most countries follow the WCO 5 guidelines for the optometry education program, the certifications provided to optometry course are diverse: such as bachelor in optometry, doctor in optometry, diploma in optometry, honors in optometry, etc. As per the framework and curriculum of these programs, it also differs from country to country irrespective of the presence of a regulatory body. For instance, in the United States, optometry education has evolved considerably in the last decade, with an increase in 5.7% of total clock hours in optometry education. 48 On the other hand, several other countries still follow the guidelines of WCO 5 and follow a specific pattern of curriculum. And eventually, after graduation, all these professionals from various countries will be titled as an optometrist. Now the question that arises here is ‘whether all the trained optometrists perform a similar role in society and are they competent to practice in all the platforms?’. To resolve this particular issue, the optometry profession might be coordinated by a global autonomous body such as WCO 5 to deliver benchmark eye care services, recommend effective recruitment strategy for optometry schools, provide uniform structure to optometry curriculum, assure the quality of academic institutes 49 and enhance the specialty practice guidelines. 50 Implementing all these components could improve the competency of the profession, increase ease of access to eye care services, reduce the burden of avoidable blindness and eventually improve the status of the profession worldwide.

A major limitation of the current study is that it applies to a small number of optometry schools, making it challenging to quantify the awareness and knowledge about optometry for the whole nation. Perceptions are expected to vary from location to location within India due to cultural, educational, environmental and language diversities. Also, there are more tertiary eye care facilities available in urban and southern parts of the country compared to its rural regions, which could lead to different degrees of awareness at different locations. Moreover, factors like academic merit, language, gender and cross-cultural difference of participants were not considered in this study. Thus, there may be a need to conduct a national survey to explore the understanding of optometry among school students. Also, awareness studies about optometry could be planned among career decision influencers such as family members, school teachers, and career counselors.

To conclude, our results provide evidence of an initial lack of awareness and knowledge about optometry among students in India. The frequency of choosing the optometry profession as a preliminary career option is low in the community. Further, it is recommended that public awareness activities should be conducted to motivate school students to seek a career in eye care. Hence, improving the awareness level of the profession may improve the quality of students’ entering optometry course. The findings also suggest that understanding the future perspectives and practice patterns of optometry services available improved considerably with the level of coursework provided at college. The outcomes recommend that trained optometrists in the country should practice optometry in all specialties independently like the developed countries, to improve the awareness level of the profession.

Conflicts of interest

The authors have no conflicts of interest to declare.

Acknowledgement

The authors would like to thank Dr Andrew Carkeet (Senior Lecturer, Faculty of Health, School - Optometry and Vision Science, Queensland University of Technology, Brisbane, Qld., Australia) for his support and guidance in manuscript preparation.

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The Journal of Optometry (J Optom) is the scientific double blind peer-reviewed publication of the Spanish General Council of Optometry ( www.cgcoo.es ). Audience of J Optom includes optometrists, ophthalmologists and visual scientists, other professionals and researchers with interests in vision and the eye as well as undergraduate and post-graduate students in those fields. The J Optom welcomes the submission of original manuscripts, reviews, case reports and scientific letters describing clinical and experimental research in all fields related with the eye and vision. Journal of Optometry is an open access journal that publishes articles in English.

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• Introduction
• Interview guide
• Preparation for the interviews and focus groups
• Data collection
• Study participants
• Data analysis
• Theme 1: retrospective perception of optometry
• Theme 2: current perception of optometry
• Theme 3: strategies to improve awareness level
• Conflicts of interest
• Acknowledgement
• Bibliography

Optometry has been an established profession in India for 60 years. Despite this, students who choose this course may have misconceptions and unrealistic expectations about the profession. The goal of this study is to understand the perceptions about optometry among optometry students, prior to and during their studies.

A snap-shot narrative qualitative study using a semi-structured open-ended questionnaire was designed to understand the perception of optometry. Optometry students and educators from three suburban colleges were invited to participate. Forty-one participants took part in 24 in-depth interviews and 5 focus groups; of those 32 were undergraduate optometry students and 9 were optometry educators. Interviews and focus groups were audio-recorded, transcribed, coded, and analyzed.

Three major themes emerged: retrospective perception of optometry, current perception and strategies to improve awareness level. All the participants mentioned that there was a considerable lack of awareness about optometry in society. None of the students stated that they chose optometry as their first choice of professional education. Most students expressed that they were provided with ample exposure during the curriculum to understand the scope of optometry. Various strategies were recommended to improve the level of awareness of optometry.

The current study highlights the lack of awareness and knowledge of optometry among the students while enrolling in the course. Knowledge about the scope of optometry practice among optometry students improved after extensive education and clinical exposure. Improving the awareness level of the profession will improve the quality of students entering the profession.

Optometric education has been established in India six decades ago, starting initially with a 2-year course, and then progressing to a 4-year graduation program. 1–3 In India, optometrists are trained in an extensive range of eye care services such as comprehensive eye examination, ocular diagnostic service, contact lenses and spectacle dispensing, vision therapy and visual rehabilitation. 4 In terms of the World Council of Optometry (WCO), Indian optometrists are highly skilled and competent. 5 They practice in multiple settings such as hospital/clinic-based practice, academics, optical retail, research, administration, marketing, and independent private practice. 6

According to the India Vision Institute report, there were approximately 49,000 practicing optometrists, and 164 institutions providing optometry education in India. 7 WCO reports that there are about 358 teaching institutes and 250,000 optometrists, globally. 5 Overall, these numbers indicate that India contributes about 19.6% of the optometrists to the world. However, the proportion might be overestimated because only 70 out of 358 known optometry organizations across the globe work in collaboration with WCO. 5,7

Despite being a well-established profession, optometric practice lacks acceptance in many countries. 8 Considering this scenario, we conducted a pilot study to explore the outlook and awareness of optometry among 9 optometry students and 2 optometry educators. Our pilot findings suggested that prior to commencing their studies, optometry students have misconceptions, false expectations and insufficient information about their profession. 9 A similar situation prevailed in many other developing countries, such as Mozambique, Saudi Arabia, and Ghana. 10–12 Eye care services in India are scattered, without formal regulation. There are no specific practice guidelines, licenses or registration for eye care professionals such as optometrists, refractionists, orthoptists, ophthalmic assistants, and ophthalmic technicians. 13 All these professions perform comprehensive eye examination and dispense spectacles and contact lenses without any specific regulatory structure, 13,14 whereas in developed countries the governments and/or law regulates the optometry education and provides practice guidelines. 15–18 Optometrists in developed countries such as the United Kingdom, Spain, Ireland, United States, Canada, Australia, and European countries play an integral role in eye care practice. 20–25 Other professions such as physiotherapy, occupational therapy, and speech therapy also lack awareness but, professions such as medicine and dentistry are well-accepted among the people in India. 19

There have been no previous studies on the perception of optometry practice or optometry education in India. With respect to other nations, India is now above the Median Development Index, with a developing middle class. So there should be increasing popularity about the role of optometrists in the country, but to the best of our knowledge, there is no current information about this. While self-efficacy and efforts are both indicators of academic success, less is known about the effects of prior career knowledge and attitudes. 10,26 Students who choose their courses with a definite career plan are more likely to have academic success 27 and students who do not actively choose their courses are less likely to finish their degrees. 28 Likewise, students who were satisfied with their chosen course were more likely to succeed in their respective careers. 29 Given the importance of prior knowledge of the profession to academic success, value of course satisfaction and lack of information about optometry students’ attitudes; a qualitative study was designed to understand the retrospective perception (i.e., the perception prior to entering the course) and current perception about optometry among optometry students, via focus group discussions and interviews.

A snap-shot narrative qualitative study was conducted using in-depth interviews and focus groups. 30 The rationale was to ensure a comprehensive understanding of the retrospective perception, present knowledge and future scopes of the profession. To obtain a broad range of perspectives, optometry students and educators (optometrist) were recruited from 1) Laxmi College of Optometry, 2) ITM Institute of Health Sciences (ITMIHS), and 3) Allied Health Science - Goa Medical College and Hospital. All the three colleges offered a four-year optometry undergraduate program and were located in suburban regions of Western India. The study was conducted in adherence to the tenets of the Declaration of Helsinki and was approved by the Institutional Ethics Committee of Goa.

A semi-structured open-ended questionnaire with probes was developed based on group discussions with optometrists engaged in student recruitment procedures and first-year undergraduate students. Questions were directed on the retrospective knowledge about optometry, present perception of the profession, future perspectives, and generalized view on awareness of optometry in the community. The interview guide was reassessed and modified after each session (interview or focus group). However, the aim of the study was not altered at any point during the study period.

The interview guide used for optometry students were as follows; 1) When did you come to know about the optometry profession?, 2) How did you come to know about optometry?, 3) What information have you heard about optometry course or optometrist prior to course enrollment? (a. Course duration, b. Subjects involved in optometry, c. Practice pattern), 4) What was the perception of optometry among your family members or relatives?, 5) After enrollment into the optometry course, what is your perception about the profession and how it is different from what you already knew?, 6) What additional information did you come across during your course work?, 7) What is the role of an optometrist in eye care services?, 8) What are the future scopes in optometry?, 9) What is your future plan in the optometry profession after graduation?, 10) What is your generalized opinion on awareness of optometry in the community and why?, 11) What is the level of awareness of optometry among your family members or relatives?, 12) What is the overall level of awareness of optometry in India?, 13) What are the factors influencing the current level of awareness? (a. Eye hospital, b. Optical, c. Government policy, d. NGO initiative, e. Community outreach programs), and 14) How can we create more awareness in the community?. For optometry educators, the questionnaire was rephrased to refer to students’ in the third person, without altering the meaning of questions. For instance, question 1 was rephrased as ‘Based on your experience, when do optometry students come to know about the profession in general?’. Likewise, the rest of the 13 questions were rephrased and used as an interview guide for the educators.

All the investigators were trained in the interview methods. English was chosen as the medium of discussion for the interviews and focus groups. A calm environment was identified in each institute to facilitate audio recording. The participants were divided into students and educators. A single moderator (DV) and a note-taker (BL) who had academic teaching experience moderated the sessions of educators. For the student participants, three moderators (SS, RK, and RKL) at three different venues and a note-taker (DV) moderated the sessions. The role of the note-taker was to record the non-verbal cues of all the participants and to assist the moderators in probing questions from the interview guide. All the interviews and focus groups were planned and carried out on separate days, which facilitated the author (DV) to transcribe the interviews and rephrase the questions in accordance with the response of the previous interview. Theoretical data saturation (redundancy of information) was considered as the endpoint of the study.

The inclusion criteria for undergraduate optometry students were that they lived within 50 km of radius from the optometry college and belonged to the suburban locality. In the second group, optometry educators with academic teaching experience of at least one year and involved in optometry course recruitment process were included. Overall, the colleges had 262 students, out of which 117 students fulfilled the inclusion criteria. Using simple randomization 53 students were invited, out of which about 90% (48/53) conveyed their willingness to participate. Among the optometry educators, a total of 10 (out of 16) educators had been involved in the recruitment process and therefore fulfilled the inclusion criteria, out of which 9 were willing to participate. All the 9 educators were invited to participate in the study. The in-depth interviews were one-on-one discussion, and each focus group had 4–5 participants. At the start of each session, the participant(s) were welcomed, and refreshments were provided. The interaction between the moderator and participant(s) began with a general discussion on weather and daily news to create a friendly atmosphere. The participant(s) were then transferred to the interview site, and the agenda of the study was explained. Written informed consent was obtained from all the participants.

The discussion began with the narration of open-ended questions (one at a time), and the participants were asked to respond to the questions in English. During the interviews and focus groups, the above-mentioned interview guide was used as a reference to direct the moderator towards the study aim. Moreover, if a participant gave an uncertain or unclear statement, their reasoning was requested: such as ‘why?’ or ‘what is your opinion on it’ or ‘how?’ or ‘when?’ or ‘anything else?’. A similar approach was administered for all the questions from the interview guide. On the other hand, if the participant did not respond to all the information on a specific question, probes were given. A scenario from the present study is given as an example: “What information have you heard about optometry course before enrollment?” If the participant had not mentioned anything about the ‘course curriculum’, then “What have you heard about the course structure and subjects undertaken in the course?”. A parallel approach was followed in focus groups; also the participants were permitted to interact with each other to derive new categories. At the end of each session, the moderator summarized all the information stated by the participant. Any terminology expressed in the local language (Hindi, Konkani, and Marathi) was translated into English by the participants. Likewise, if any non-verbal cues were used during the session, the participant(s) were requested to express verbally. The data collection was concluded when no additional insights were obtained in the last 3 sessions.

After, 24 in-depth interviews and 5 focus groups in two groups of 41 participants; data saturation was observed. Thirty-two undergraduate optometry students participated in 20 interviews and three focus groups (four participants in each) in group 1, among which 6 students belonged in the first-year, 7 in the second-year, 11 in the third-year and remaining 8 were optometry interns. None of the participants from the student group took part in both the interviews and focus groups. Four in-depth interviews and two focus groups (4 in first and 5 in second) were carried out among nine educators. Four tutors participated in interviews as well as focus groups.

The audiotaped in-depth interviews and focus groups were transcribed into verbatim by the moderators who conducted the interview. Each transcript was descriptively coded, and categorized by a single moderator (DV). Generalized data coding and analysis were carried out for all transcribed interviews and focus groups irrespective of the study group using NVivo 12 software (NVivo qualitative data analysis software; QSR International Pty Ltd. Version 12.0, 2018). The software helped organize and retrieve text linked by familiar texts. Qualitative content analysis was performed to compare the responses between two groups and the level of course completion.

The 32 undergraduate optometry students who took part had a mean age of 19.36 ± 1.28 (SD) years, of which 21 participants were female. The 9 optometry educators who participated had a mean age of 30.5 ± 2.02 (SD) years and had a mean level of teaching experience of 3.83 ± 2.25 (SD) years respectively, of these educators 5 were female. The categories obtained from both groups were similar, as the study aimed to address the perception of the student community. Three major themes that emerged out of the qualitative analysis are as follows.

The outlook of optometry in society

“Most of the people in India have never heard about optometry or optometrist.” (Interview 03: Educator)

“There is no awareness of optometry in society. Even when I informed my relatives that I am pursuing an optometry course; they asked, ‘What is optometry exactly?’ Then I had to explain to them about the course and the role of an optometrist in society.” (FGD 01; P26: Student)

The reasons to undertake the course

Students’ response

“I wanted to pursue Medicine, but I couldn’t meet the eligibility criteria. I was keen on providing community service, so I started looking for other career options in health care. I came across the optometry program; I felt optometry would be an ideal career where I can serve the rural community.” (Interview 03: Student)

“While preparing for competitive examinations for health-care, I went through different courses that were available in my state (locality). That was the first time I heard that there is a branch called optometry that deals with eye care.” (Interview 17: Student)

“I read online that optometrists had very high job satisfaction in many countries compared to other health-care professions; so I opted for optometry.” (Interview 18: Student)

Educators’ response

“Some students were pursuing optometry because they required optometry skills and graduation certificate to carry over their family business (i.e. optical industry).” (Interview 02: Educator)

“Few students discontinue optometry course if they get into medicine or dental education.” (FGD 05; P39: educator)

Expectation(s) from the course

“I knew that optometry is a profession related to the eyes. I also had a thought that it is similar to an ophthalmologist except providing surgical management and drug administration.” (Interview 21: Student)

“Before entering the course, I thought an optometrist had to work in lens manufacturing units, and optical sales after completion of the course.” (Interview 7: Student)

According to the educators, first-year optometry students had inadequate knowledge about the coursework, curriculum, structure and future scopes. Likewise, some students reported that they did not have substantial information about the subjects in the syllabus and scope during the admission process. None of the students had heard about multidisciplinary practice patterns of optometry prior to the commencement of their course.

Understanding the role of an optometrist

“After completing the coursework of specialty subjects such as contact lenses, binocular vision, and low vision in the third year; I am quite confident that the optometry profession has plenty of scopes.” (Interview 15: Student)

The future scope of optometry

“Our college organizes yearly school screening programs at rural schools where we conduct vision assessment of the students and prescribe glasses. This experience has inspired me a lot, so I am considering to concentrate on pediatric optometry.” (Interview 11: Student)

The first two themes highlighted the lack of awareness of optometry in India, which led to the development of this theme. Two subthemes were derived; the role of media and public health awareness.

a. Role of media

“Media is an influential source for publicity these days; we can advertise on radio, newspapers, and television channels about optometry courses and clinics. We have thousands of friends at the social media platform, which makes it the best option to promote optometry.” (FGD 02; P28: Student)

b. Public awareness programs

“I came to know about optometry from an eye screening camp conducted near my residence. There were hundreds of people being screened and referred to eye hospital, and some were given free spectacles too. So, organizing multiple camps in the community will also create awareness about the role of an optometrist.” (FGD 03; P31: Student)

“I feel our graduates should initiate more of independent practice to improve the awareness level of optometry, rather than working in eye hospitals or optical chains. Also, we (optometrists) need the support of a national regulatory body; like the Medical Council of India and Dental Council of India to support physicians and dentists respectively.” (Interview 02: Educator)

“We organize public awareness programs and vision screening programs to create awareness about optometry.” (FGD 05; P40: Educator)

Our findings showed that, prior to entering the course, the awareness and knowledge about the optometry profession were limited among optometry students. A majority of students had heard about health-care professional courses like medicine, dentistry, and nursing during their schooling but not optometry. Moreover, most student participants in this study never intended to choose optometry as a profession in the first place. The current study results highlighted that students with good academic merits prefer medicine or other professions initially, and settle to optometry profession when failed to procure their desired profession.

The time point at which the students learn about the role of a profession is crucial. The student participants acquired basic knowledge about optometry course at the age of 17.6 (±1.2) years, which was also the time they gathered information about the career options in the health-care. Literature suggests early-to-mid adolescence is the ideal time for career exploration. 31 However, the students in this study had never heard about optometry until late adolescence, and the opinion was also backed by optometry educators. Many students perceived optometrists as spectacle dispensers or lens manufacturers when they heard about the profession for the first time. The students also reported that their family members, relatives, and peers did not perceive the profession at par with other health-care professions prior to commencement of the course. Even in most European countries, optometrists were perceived as opticians for the initial five decades. 20 Our findings also suggested that a similar situation prevails in India currently (60 years after the introduction of optometry 1–3 ). In addition, few studies have indicated a lack of awareness about the optometry profession in developing nations such as Mozambique, Ghana and Saudi Arabia. 10–12,32,33 Overall, the reason behind this lack of knowledge and awareness about optometry in these countries is not known.

Our study also showed that prior to entry, students were more aware of medicine, dentistry, and nursing compared to optometry. The roles of other professions such as physiotherapy, occupational therapy, and speech therapy are, like optometry, relatively unknown in India. 19 However, in contrast, the roles of optometry are well-understood by college students of the United States. 34 A reason for this finding could be the existence of a large number of optometrists in the United States, and there is a high probability that the participants’ encounter the profession at some point in time. The national and state regulatory bodies moderating US optometry practice might also have played a major role in enhancing the reputation of the profession. 34 Nevertheless, our results suggested that vision care services being provided in the community might contribute to the existing awareness of optometry. This agrees with other studies, which also suggest that the role of eye care hospitals and community outreach programs remains vital in generating awareness about optometry in young people and their families. 35,36 In addition, career counselors and family members were the source of information about optometry in this study. Literature suggests that parents and school teachers commonly influence school students in career decisions making. 37 Surprisingly, none of the student participants in the present study stated that their school teachers, or school counseling professionals, mentioned or discussed optometry. This indicates that there could be a considerable lack of awareness about optometry in school teachers, career counselors, and society. In the current study, the desire to help the community, support family business and job opportunities were mentioned as factors for opting optometry. Similar findings were also reported in the literature. 38,39

The perception of optometry students about their career changed after appropriate academic and clinical exposure to eye care. The students also highlighted that their family members, relatives, and peers viewed the profession positively after they enrolled in the course compared to their previous understanding. After entering the course, the students came across various aspects of optometry coursework which lead them to gain knowledge about future scopes and practice patterns in optometry. To the best of our knowledge, there are no studies that reported the changes in perception of optometry among the students pursuing the profession. A study by Thite et al. 6 reported that the Indian optometrists were involved in a range of services at eye hospitals, optical outlets, and community outreach programs. These findings are similar to our results, however, the retrospective perception of optometry showed conflicting responses which indicate a lack of initial knowledge about optometry practice. In addition, senior optometry students had a better understanding and knowledge of the career opportunities, range of vision care services and scope of practice, compared to their juniors. This suggests that optometry students need sufficient exposure and guidance to various eye care services during the curriculum to understand the broader perspective of optometry. Similarly, the literature also suggests that the knowledge about the range of practice patterns and the importance of multidisciplinary approach was higher among senior students and optometrists with higher academic qualifications, indicating the importance of more exposure. 6,40 These findings emphasize that the quality of education and optometry qualification are crucial in understanding the roles of the profession. In addition, De Souza et al. 4 and Rao 41 discussed the need for extensive training to deliver a successful eye care service in India. Thus, the standards of optometry education and the quality of eye care services may depend on the framework of the academic curriculum pursued by the students. Currently, there is no standard curriculum followed by the optometry colleges in India, and developing such a curriculum may improve the profile of the profession.

Overall, the results of the current study highlight the urgent need to create awareness about optometry in suburban India. Assessing and generating awareness about optometry prior to course enrollment will not only improve the intake of meritorious students, but also enhance academic performance, 10,27,42 professional success, 29 and future job satisfaction. 43 A study by Grembowski et al. 44 illustrated a positive association between job satisfaction and quality of health care service provided. Thus, improving the current perception of students would also result in delivering a better quality eye care service to the community. Several innovative approaches were suggested by the participants to improve public awareness and knowledge about the optometry profession in the present study. Participants suggested that community activities could be used as a platform to improve the awareness level of the profession. Advertisements were also one of the strategies recommended to improve awareness about optometry. A similar approach was suggested by Moser and Reed to improve public awareness and to ensure an advantageous optometry practice. 45 Literature suggests several developing countries have a lack of knowledge about eye care service and optometrist in their community. 10–12,32,33 The strategies identified in our study could be implemented in these countries where awareness about optometry among career seeking students is minimal. Apart from awareness of the optometry profession, the participants also reported that these strategies will create awareness about eye health in society. Similar strategies were recommended to improve eye health in the previous studies. 4,45 The current study highlights that several false assumptions might prevail about optometry among the student community. These misconceptions about the profession might diminish significantly if the proportion of independent practice increases resulting in general-public encountering the profession in large numbers and building awareness in the country. A study in the United States reported that the high proportion of practicing optometrists influenced the exposure to the profession among college entering students. 34 However, the proportion of independent optometry practice in India was reported only 22%. 6

Optometry educators emphasized the need for a national legislative body for independent optometry practice in the current study. This expectation is customary because of the existence of Medical Council of India and Dental Council of India which allows physicians and dentists to practice independently. Furthermore, there are different professionals in eye care such as optometrists, refractionists, orthoptists, ophthalmic assistants, and ophthalmic technicians who provide refractive services. 13 Whereas the role of eye care practice in developed countries are well-defined, this might be due to the presence of regulatory bodies in their nations, that maintains the standards of the services by stratifying the responsibilities of eye care practitioners. 20–25 At present, India is planning to establish a legislative and regulatory body for standardizing optometry education and moderating the practice guidelines of an optometrist in the country as suggested by the WCO. 5,46,47 Though most countries follow the WCO 5 guidelines for the optometry education program, the certifications provided to optometry course are diverse: such as bachelor in optometry, doctor in optometry, diploma in optometry, honors in optometry, etc. As per the framework and curriculum of these programs, it also differs from country to country irrespective of the presence of a regulatory body. For instance, in the United States, optometry education has evolved considerably in the last decade, with an increase in 5.7% of total clock hours in optometry education. 48 On the other hand, several other countries still follow the guidelines of WCO 5 and follow a specific pattern of curriculum. And eventually, after graduation, all these professionals from various countries will be titled as an optometrist. Now the question that arises here is ‘whether all the trained optometrists perform a similar role in society and are they competent to practice in all the platforms?’. To resolve this particular issue, the optometry profession might be coordinated by a global autonomous body such as WCO 5 to deliver benchmark eye care services, recommend effective recruitment strategy for optometry schools, provide uniform structure to optometry curriculum, assure the quality of academic institutes 49 and enhance the specialty practice guidelines. 50 Implementing all these components could improve the competency of the profession, increase ease of access to eye care services, reduce the burden of avoidable blindness and eventually improve the status of the profession worldwide.

A major limitation of the current study is that it applies to a small number of optometry schools, making it challenging to quantify the awareness and knowledge about optometry for the whole nation. Perceptions are expected to vary from location to location within India due to cultural, educational, environmental and language diversities. Also, there are more tertiary eye care facilities available in urban and southern parts of the country compared to its rural regions, which could lead to different degrees of awareness at different locations. Moreover, factors like academic merit, language, gender and cross-cultural difference of participants were not considered in this study. Thus, there may be a need to conduct a national survey to explore the understanding of optometry among school students. Also, awareness studies about optometry could be planned among career decision influencers such as family members, school teachers, and career counselors.

To conclude, our results provide evidence of an initial lack of awareness and knowledge about optometry among students in India. The frequency of choosing the optometry profession as a preliminary career option is low in the community. Further, it is recommended that public awareness activities should be conducted to motivate school students to seek a career in eye care. Hence, improving the awareness level of the profession may improve the quality of students’ entering optometry course. The findings also suggest that understanding the future perspectives and practice patterns of optometry services available improved considerably with the level of coursework provided at college. The outcomes recommend that trained optometrists in the country should practice optometry in all specialties independently like the developed countries, to improve the awareness level of the profession.

The authors have no conflicts of interest to declare.

The authors would like to thank Dr Andrew Carkeet (Senior Lecturer, Faculty of Health, School - Optometry and Vision Science, Queensland University of Technology, Brisbane, Qld., Australia) for his support and guidance in manuscript preparation.

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