Changes in attitudes and practices of optometrists in their management of diabetic retinopathy after the release of NHMRC guidelines

The purpose of this study was to document attitudes and practices of Austra lian optometrists in their management of diabetic retinopathy prior to the release of the National Health and Medical Research Council (NHMRC) Clinica l Practice Guidelines for the Management of Diabetic Retinopathy and at two time points following their release. A self- administered questionnaire wa s mailed to a stratified random sample of 500 Australian optometrists at th e three time points. The same sample was used for the first two surveys and a new random sample was drawn for the second follow-up survey. The respons e to the three questionnaires was 86%, 80% and 84%, respectively. More than 90% of optometrists reported receiving a copy of the guidelines and 82% re ported receiving the supplementary Retinopathy Chart. Fifty-seven per cent reported having read the guidelines at least once in entirety and 65% repor ted that they refer to the Retinopathy Chart at least monthly in their clin ical practice. There was a significant decrease in the number of optometris ts who reported that patient unwillingness to be dilated and their fear of precipitating angle closure glaucoma were moderate or major barriers to per forming dilated ophthalmoscopy. Concomitantly, the percentage of optometris ts who reported that they often or always perform dilated ophthalmoscopy on new patients with diabetes increased significantly from 74.5% (95% confide nce limit = 70.2, 78.8) to 81.5% (95% confidence limit = 77.5, 85.5). There have been some significant changes in the self-reported management practic es of optometrists in relation to diabetic retinopathy since the release of the NHMRC guidelines and Retinopathy Chart.