École d'optométrie – Travaux et publications

URI permanent de cette collectionhttps://hdl.handle.net/1866/19186

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Accès libre
Accessing emergency eye care by therapeutically qualified optometrists : a simulated-patient study in Quebec, Canada
Tousignant, Benoît ; Binette, Catherine; Duchesne, Ariane; Université de Montréal. École d'optométrie (Taylor and Francis, 2025-03)
Clinical relevance Therapeutically qualified optometrists are important providers of emergency eye care. To provide insight on how to optimise a population’s accessibility to emergency care, it is helpful to examine factors which go beyond the scope of practice and number of practitioners in a jurisdiction. Background Therapeutically qualified optometrists play an important role in managing ocular emergencies. This study assesses the accessibility of emergency eye care for a new patient in Quebec and explores associated factors such as geographical region of practices and morbidity of patient symptoms. Methods Cross-sectional study using simulated-patient design. Scripted phone calls were placed to optometry practices, posing as patients seeking emergency care. A random sample of Quebec practices was stratified by region: urban, peri-urban, and rural. Each practice received one call for a simulated conjunctivitis (low morbidity) and one for a simulated retinal break (high morbidity). Outcomes included obtaining an appointment, time-to-appointment and out-of-pocket costs. Results Eighty-nine practices participated: 30 urban, 30 peri-urban and 29 rural. Some 46% of practices granted at least one eye emergency appointment (n = 41) with significant differences between regions: 40% in urban areas, 30% in peri-urban areas and 69% in rural areas (p = 0.008). Overall, median delay to obtain an appointment was 3.7 hours (interquartile range = 1.8 – 6.3) and median fee was 55 Canadian dollars (interquartile range 50 – 65). Low-morbidity appointments were granted slightly more often (p = 0.07). Neither time-to-appointment nor fees differed significantly with morbidity or type of region. Conclusion In this simulated-patient study, less than half of optometry practices offered an emergency appointment to new patients in Quebec; more appointments were granted in rural areas and for low morbidity conditions. In a jurisdiction with many therapeutically qualified optometrists across its territory, accessibility to emergency eye care was somewhat limited, with significant geographical differences.
Accès libre
Barriers and facilitators to eye care among homeless adults in Montreal, Canada
Messier, Annabelle; Barré , Victoria; Faucher , Caroline; Tousignant, Benoît; Université de Montréal. École d'optométrie (Canadian association of optometrists., 2024)
Purpose People experiencing homelessness have higher prevalence of health and eye problems than the general population and are less likely to access healthcare services, despite universal healthcare coverage in Canada. This study aims to describe the competing priorities to healthcare and the barriers and facilitators to eye care for homeless adults in Montreal (Canada), exploring potential differences between genders. Methods Cross-sectional study conducted in homeless shelters in Montreal, following stratified randomization. A questionnaire was adapted from existing validated items on competing priorities as well as on barriers and facilitators. Items explored included costs, accessibility and transportation, trust and previous experiences and health literacy. Comparisons were made using chi-squared and Mann-Whitney U tests. Results Six shelters for the homeless were approached and accepted to serve as data collection sites. Sixty-two participants completed the questionnaire and 51.6% (n = 32) identified as women. In all, 69.4% (n = 43) of participants had valid eye care coverage. Half of participants (n = 31) had not consulted an optometrist or ophthalmologist in ≥ 3 years. Nearly a quarter (24.2%, n = 15) of participants reported having at least one strongly competing priority. Prohibitive costs were the most strongly identified barrier, with a group median score of 4.0 (IQR 2.0-5.0). Complexity of coverage procedures seemed to be a barrier mostly for men (median score 4.0 [IQR 3.0-5.0] on a 5-point Likert scale). Strong facilitators included trust in optometrists (median 1.0 [IQR 1.0-2.0]) and having more than one health and social services in the same location (median 1.0 [IQR 1.0-2.0] on a 5-point Likert scale). No statistical differences were found between men and women. Conclusion For adults experiencing homelessness in Montreal, despite large coverage for eye care services, competing priorities and prohibitive costs are strong barriers to seeking care. Trust in optometrists and the grouping of health services are notable facilitators. These data may help develop more inclusive strategies for delivering eye care to this underserved population.
Accès libre
The nature of multi-channel color perception from three photodetector types with wide overlapping spectral sensitivity bands
Diaconu, Vasile; Faubert, Jocelyn; Université de Montréal. École d'optométrie (Optica, 2024)
Human color perception generates typical chromatic sensations from various wavelengths of the visible spectrum by exciting three broadband sensitivity photodetector types. The retinal neural network compares, differentiates, and redirects signals from the three photodetectors to the cortex through several chromatic pathways. The current concept that explains the creation of the different color pathways through the retina's neural network is not compatible with its implementation in a physical instrument to characterize colors in a way similar to the visual system so the mechanism of neural color-coding of the retina is partially known. The present paper presents a physical process of de-multiplexing signals emitted by two or more types of photodetectors with a wide band of overlapping spectral sensitivities to differentiate signals corresponding to the spectral zones that the photodetectors share, and signals corresponding to the distinctive spectral sensitivity zone of each photodetector. The model adopts two fundamental principles from retinal neuron signal processing, such as the contrast of photoreceptor signals, as well as the ON and OFF properties of the retina's neural network to redirect the contrasts of photoreceptor signals to different chromatic channels. The concept of this model represents a good alternative to explain the process of color coding signals from three types of retinal photodetectors to activate the different channels involved in human color perception.
Accès libre
3D printing as assistive technology for individuals with deafblindness : perspectives of rehabilitation professionals
Bleau, Maxime; Jaiswal, Atul; Holzhey, Peter; Wittich, Walter; Université de Montréal. École d'optométrie (Taylor and Francis, 2024-11-21)
here is a growing body of evidence on practical applications of three-dimensional (3D) printing to support the rehabilitation of individuals with sensory impairments. However, applications in the field of deafblindness, or the combination of vision and hearing impairment, remain scarce. Therefore, the present study aimed to explore actual and potential applications of 3D printing in deafblindness rehabilitation from the perspective of rehabilitation professionals in two focus group discussions that involved orientation and mobility specialists, vision rehabilitation specialists, audiologists, and braille technicians. Participants exchanged on 1) 3D printing applications to address their clients’ rehabilitation needs, 2) factors that can impact its integration into their practice, and 3) the ideal logistics for producing and delivering 3D printed products. Educative models and functional adaptations were identified to improve communication, learning, mobility, and independent living skills for individuals with deafblindness. Professionals agreed that the main barriers limiting 3D printing adoption were linked to time constraints and insufficient awareness or knowledge about this technology, while the most crucial facilitator was the promotion of interdisciplinary collaborations with 3D printing experts. The present findings thus emphasize the need for global collaborations, knowledge dissemination, and ongoing research and validation of 3D printing applications to support individuals with deafblindness. IMPLICATIONS FOR REHABILITATION 3D printing is a promising tool to produce tactile educational material and functional adaptations that can improve learning, mobility, and independent living skills for individuals with deafblindness; examples from this study included actual and potential applications of 3D printing within deafblindness rehabilitation. 3D printing offers the possibility to produce specialized material that can improve communication between rehabilitation professionals and clients with deafblindness, thus improving and accelerating interventions. Insufficient knowledge dissemination about 3D printing and associated possibilities is the main barrier to its adoption by professionals and is potentially more important than time and budget concerns. Rehabilitation professionals expressed the need and interest for efficient collaboration with 3D printing experts with the goal of co-designing customized tools that respond to the unique needs and challenges of individuals with deafblindness.
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Follow-up in low vision rehabilitation for users of assistive technology : a scoping review
Aminparvin, Hamidreza; Henrichs, Leif; Auger, Claudine; Dumassais, Shirley; Renaud, Judith; Wittich, Walter; Université de Montréal. Faculté de médecine. École de réadaptation; Université de Montréal. École d'optométrie (Taylor and Francis, 2024)
Assistive technology (AT) is crucial for aiding activities of daily living in individuals with visual impairment; yet, without systematic follow-up device abandonment rates remain high. This scoping review synthesizes existing literature on follow-up processes in individuals with visual impairment undergoing vision rehabilitation with AT. Employing the Arksey and O'Malley framework, this review comprehensively searched seven databases, identifying 1,061 articles, of which 43 were selected for analysis, using the concepts of visual impairment, rehabilitation, and assistive technology. The publications span from 1989 to 2022. Most studies (n=36, 83%) utilized a mixed-methods design, and 51% (n=22) originated from the United States. Devices for near vision were the most commonly prescribed type of AT. Follow-up methods included questionnaires and interviews, with most follow-ups conducted at the client's home. Follow-up timing varied across studies, whereby 37% (n=16) occurred after one or more years and 33% (n=14) between one week and four months. Three categories of outcome measures emerged: generic outcomes, task-specific outcomes, and a combination of both. The review identified several gaps in the literature, including a scarcity of research concerning follow-up of AT particularly for both the type and timing of follow-up.
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Access to emergency eye care appointments in Quebec, Canada : a simulated patient study
Tousignant, Benoît; Binette, Catherine; Duchesne, Ariane; Université de Montréal. École d'optométrie (2023-10-12)
Purpose Optometrists play an important role in primary eye care, including providing ocular emergency consultations. This study aims to describe the accessibility of ocular emergency appointments for new patients in optometry practices throughout Quebec, Canada. Methods This cross-sectional study assesses the possibility to obtain an appointment, along with associated delays and costs in optometric practices in Quebec, Canada. Simulated patients calls, taking the role of a new patient seeking an emergency appointment, were made in 89 clinics across the province, divided between urban, semi-urban and rural areas. Each clinic received one call for a low morbidity emergency (acute red eye), and one call for a high morbidity emergency (recent onset of flashes). Descriptive statistics were performed, along with intra- and inter-group comparisons using parametric (χ2) or non-parametric tests (Fisher’s exact test, Wilcoxon signed-rank test, Kruskal-Wallis H test). Results The proportion of the clinics that granted at least one eye emergency appointment was 46.1%, with differences according to areas: 40% in urban areas, 30% in semi-urban areas and 68.9% in rural areas (X2 [2, N = 89] = 9.7, p = 0.008). The median delay was 3.72h (IQR = 4.6) and the median price for an ocular emergency appointment was 55 CAD$ (IQR 15.0). Obtaining at least one type of appointment was more probable in rural areas compared to urban areas (X2 [1, N = 60] = 3.28, p = 0.004), or to semi-urban area (X2 [1, N = 60] = 6.67, p = 0.001). However, patient scenarios with high morbidity conditions did not yield better chances of obtaining an appointment than those with a low morbidity condition (X2 [1, N = 178] = 0.23 p = 0.63). There were no differences between areas for median delays (Kruskal-Wallis, H(2) 2,2 = p < 0,3), nor for median prices of an ocular emergency appointment (Kruskal-Wallis, H(2) 3,535, p = 0,17). Conclusion The proportion of optometry clinics offering emergency appointments to new patients in Quebec is uneven, ranging from 30% to 68.9%, favoring rural practices. Median delays and median prices of an ocular emergency appointment seem uniform across the province regardless of morbidity. These data can be useful in planning and advocacy efforts to improve accessibility to emergency eye care services in Quebec.
Accès libre
Vision and hearing impairment and occupational therapy education : needs and current practice
Wittich, Walter; Jarry, Jonathan; Barstow, Elizabeth; Thomas, Aliki; Université de Montréal. École d'optométrie (SAGE, 2017)
Introduction It is unclear what sensory impairment screening content should be included in the core-educational process for occupational therapists. The purpose of this study was to identify what content is currently being taught with regard to screening for vision and hearing loss, and to gather recommendations from specialists in this field of practice in order to formulate recommendations to improve professional entry-level occupational therapy curriculum content. Method Using a mixed-methods design, the two-phase study investigated the perceptions of five curriculum chairs, as well as 10 occupational therapists specializing in sensory rehabilitation. Results Curriculum chairs reported minimal course content with regard to training in the sensory domain, a dearth that was corroborated by specialists working with individuals affected by sensory loss. While vision-related topics were well covered, hearing-related information was sparser, and dual sensory impairment was mostly absent. Conclusion Occupational therapists are well positioned to play an essential role with the population living with sensory loss. However, most clinicians are not adequately prepared to practice with this clientele, and most expertise is gained after graduation. There is a need for stakeholders to discuss the minimal acceptable curriculum content needed to ensure that graduates are prepared to work in this growing area.
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Sensory and demographic characteristics of deafblindness rehabilitation clients in Montreal, Canada
Wittich, Walter; Watanabe, Donald H.; Gagné, Jean-Pierre; Université de Montréal. École d'optométrie (Wiley, 2012-02-21)
Purpose: Demographic changes are increasing the number of older adults with combined age-related vision and hearing loss, while medical advances increase the survival probability of children with congenital dual (or multiple) impairments due to pre-maturity or rare hereditary diseases. Rehabilitation services for these populations are highly in demand since traditional uni-sensory rehabilitation approaches using the other sense to compensate are not always utilizable. Very little is currently known about the client population characteristics with dual sensory impairment. The present study provides information about demographic and sensory variables of persons in the Montreal region that were receiving rehabilitation for dual impairment in December 2010. This information can inform researchers, clinicians, educators, as well as administrators about potential research and service delivery priorities. Method: A chart review of all client files across the three rehabilitation agencies that offer integrated dual sensory rehabilitation services in Montreal provided data on visual acuity, visual field, hearing detection thresholds, and demographic variables. Results: The 209 males and 355 females ranged in age from 4 months to 105 years (M = 71.9, S.D. = 24.6), indicating a prevalence estimate for dual sensory impairment at 15/100 000. Only 5.7% were under 18 years of age, while 69.1% were over the age of 65 years, with 43.1% over the age of 85 years. The diagnostic combination that accounted for 31% of the entire sample was age-related macular degeneration with presbycusis. Their visual and auditory measures indicated that older adults were likely to fall into moderate to severe levels of impairment on both measures. Individuals with Usher Syndrome comprised 20.9% (n = 118) of the sample. Conclusion: The age distribution in this sample of persons with dual sensory impairment indicates that service delivery planning will need to strongly consider the growing presence of older adults as the baby-boomers approach retirement age. The distribution of their visual and auditory limits indicates that the large majority of this client group has residual vision and hearing that can be maximized in the rehabilitation process in order to restore functional abilities and social participation. Future research in this area should identify the specific priorities in both rehabilitation and research in individuals affected with combined vision and hearing loss.
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The Purdue Pegboard test : normative data for older adults with low vision
Wittich, Walter; Nadon, Christina; Université de Montréal. École d'optométrie (Taylor and Francis, 2016-01-08)
Purpose The usability of assistive technologies depends, in part, on the user’s ability to manipulate the device. In the context of aging and visual impairment, the visibility of any device and its components becomes crucial, and often users rely on tactile information in order to overcome visibility barriers. The purpose of this study was to establish performance norms for older adults with low vision on a common measure of manual dexterity: the Purdue Pegboard Test. Method The Purdue Pegboard was completed visually with the dominant, non-dominant and both hands by 134 older adults (age 60–97) with various levels of low vision, ranging from 20/30 to 20/604 in the better eye. Results Scores decreased significantly as age increased. In addition, performance using the dominant hand was generally best. Compared to previously published values, scores were lower than the norms for healthy older adults as well as those for younger visually impaired individuals. Conclusions The present values for older adults with low vision add to the already existing standards and allow for comparison among future studies with this population. Systematic examination of manual dexterity in low vision clients will enable rehabilitation specialists to make more informed recommendations in terms of usable low-vision devices.
Accès libre
Comparison of refractive outcomes between a tele-eye care comprehensive eye exam and a gold standard in-person eye exam
Blais, Nicolas; Université de Montréal. École d'optométrie (2022)
Accès libre
Télé-optométrie : comparaison de l’examen visuel à distance avec l’examen présentiel Gold standard
Blais, Nicolas; Brisson, Fannie; Université de Montréal. École d'optométrie (2022)
Objectif : Le rôle de la télé-optométrie est peu délimité dû au manque d’études. Cette étude expérimentale prospective à mesures répétées en ordre aléatoire vise à comparer le nombre de résultats de santé oculaire hors des normes cliniques, à comparer le niveau de confiance des optométristes envers ces résultats et à comparer les diagnostics de santé oculaire entre les examens présentiel et télé-optométrique. Méthode : Trente-cinq participants (21-58 ans) ont subi un examen optométrique Gold standard présentiel et un examen télé-optométrique mené par un technicien présentiel et un optométriste en vidéoconférence via la plateforme DigitalOptometricsTM. Les résultats d’examen ont été catégorisés selon leur respect des normes cliniques et les optométristes ont donné un indice de confiance aux résultats pour chaque modalité. Le coefficient alpha de Krippendorff (a), le test de McNemar (p) et le test de rangs signés de Wilcoxon (p) ont été utilisés pour comparer les deux modalités. Le nombre de diagnostics communs entre les modalités a également été analysé. Résultats : Tous les résultats d’examen étaient statistiquement équivalents pour les tests de santé oculaire (a>0,50), sauf pour les motilités oculaires (a=0,25; p=0,06). Les optométristes ont rapporté un niveau de confiance significativement plus élevé pour la modalité présentielle (97±1%) en comparaison avec la télé-optométrie (77±3%) (p< 0.001). Vingt-cinq diagnostics ont été posés à distance et 23 en présentiel. Quatorze (29%) de ces diagnostics, soit huit posés en présentiel et six à distance, ne concordaient pas entre les deux modalités, mais étaient de faible morbidité. Discussion : Nos données suggèrent que pour un examen général, le niveau de confiance des optométristes est statistiquement inférieur en télé-optométrie. Cependant, les deux modalités d’examen démontrent une habilité équivalente à détecter les résultats de santé oculaire hors normes, sauf pour les motilités oculaires. La morbidité des diagnostics devrait être gradée dans de futures études. Source de financement : Cette recherche a reçu le soutien de Mitacs dans le cadre du programme Mitacs Accélération en partenariat avec IRIS Le Groupe Visuel, ainsi que le soutien d’Innova, de DigitalOptometrics et du FDERC.
Accès libre
The eyelash follicle features and anomalies : a review
Aumond, Sarah; Bitton, Etty; Université de Montréal. École d'optométrie (Elsevier, 2018-07-17)
The primary role of eyelashes is to protect and maintain the health of the lid margin. However, the mechanisms to fulfill this role are not fully understood. Unraveling these mechanisms will stand to greatly improve the efficiency of eye care professionals’ interventions in anomalies of the eyelashes. The aim of this article is to provide a review on eyelashes including highlights and new avenues for research; the biology of both the lash and its follicle; the pathophysiology and management of lash anomalies by eye care professionals; and the effect of iatrogenic factors on lashes. Using the database of Ovid MEDLINE, we reviewed studies specifically directed on human/mammalian eyelashes and key articles on current trends in scalp hair methodologies that can be applicable to lash research. The eyelash morphology, pigmentation and growth rate have been documented using techniques ranging from lash imaging to follicle immunohistochemistry. Furthermore, studies have demonstrated that the lash follicle is sensitive to many factors of the external environment, a variety of systemic/topical medications and cosmetics. Recently, aerodynamic studies using a mammalian eye model confirmed that an optimal lash length was needed so that eyelashes serve a protective role in reducing the number of particles that can reach the eye. Despite recent advances in lash research, studies are still scarce, due to the limited availability of the human lid for sampling. This review brings awareness that further research is needed with respect to eyelashes and will hopefully reduce the gap with scalp hair research.
Accès libre
Téléréfraction : comparaison d’une réfraction présentielle et d’une réfraction réalisée à distance
Blais, Nicolas; Le Borgne, Magali; Hanssens, Jean-Marie; Université de Montréal. École d'optométrie (2021-04-09)
Objectif : Comparer les résultats de puissances sphéro-cylindriques, d’acuité visuelle, de confort visuel et d’appréciation entre deux réfractions, l’une en présentiel (Gold Standard) et l’autre à distance (téléréfraction). Méthode : Deux étapes randomisées ont été effectuées par deux étudiants-chercheurs en optométrie, sur 32 participants. La première consistait à mesurer l’erreur réfractive des participants avec un visiomètre électronique qui pouvait être contrôlé à distance, selon un ordre aléatoire, une fois avec une réfraction présentielle et une fois avec une téléréfraction par vidéoconférence. Un questionnaire d’appréciation de la modalité était rempli après chacune des réfractions. Lors de la seconde étape, réalisée en double aveugle, les participants ont essayé en lunettes d'essai les réfractions obtenues, et les acuités visuelles en vision de loin ont été mesurées. Un questionnaire de confort était également rempli après chacun des essais. Résultats : Des tests de rangs signés de Wilcoxon ont été utilisés. Aucune différence statistiquement significative n’a été constatée au niveau réfractif avec une analyse vectorielle des puissances sphéro-cylindriques. La sphère équivalente moyenne obtenue à distance (x=-1.118D±2.128) était légèrement plus convexe que celle en présentiel (x=-1.200D±2.034). Pour l’astigmatisme, les vecteurs J0 étaient égaux (x=-0.041D ; p=0.616) et les vecteurs J45 étaient très peu différents (p=0.823). L’acuité visuelle moyenne en LogMar ne montrait pas de différence statistiquement significative (p=0.541). Une seule question sur le confort visuel a montré des différences significatives entre les deux lunettes d'essai. En ce qui concerne l’appréciation des deux modalités de réfraction, 4 questions sur 5 ont montré des différences statistiquement significatives avec une préférence pour la modalité présentielle. Conclusion : Il n'y a aucune différence statistiquement significative pour la réfraction et l’acuité visuelle entre le Gold Standard et la téléréfraction. Cependant, le fait que la télé-optométrie n’est pas très présente au Québec peut expliquer que la téléréfraction soit moins appréciée que la réfraction présentielle.
Accès libre
GUSTO : une intervention culinaire proposée en milieu communautaire pour améliorer la capacité à cuisiner et les fonctions cognitivo-motrices et exécutives chez les aînés en bonne santé
Poncet, Frédérique; Downey, Rachel; Mckinley, Patricia; Li, Karen; Université de Montréal. École d'optométrie (Association nationale française des ergothérapeutes, 2021)
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Longitudinal study on ocular manifestations in a cohort of patients with Fabry disease
Michaud, Langis; Université de Montréal. École d'optométrie (Public library of science, 2019-06-27)
Purpose This study aims to assess the evolution of ocular manifestations in a cohort of Fabry patients. Methods This is a prospective observational study conducted from 2013 to 2017 (5 consecutive exams). All subjects underwent a comprehensive ocular examination including oriented case history, refraction, corneal topography, biomechanical corneal properties and pachometry assessments, aberrometry, anterior segment evaluation, double-frequency visual field (FDT), intra-ocular pressure, and ocular fundus. At baseline, 41 subjects enrolled but 9 dropped-out and 4 files were not kept for analysis (missing data). Remaining 28 subjects were classified into: Group 1 -hemizygotes (HMZ), all on enzyme replacement therapy (ERT) (N = 10); Group 2 -heterozygotes (HTZ) actively ERT-treated (N = 8), and Group 3 -HTZ not treated (N = 10). Results There is a high intra and inter-subjects variability. At baseline, prevalence of the ocular manifestations found is similar to published data: cornea verticillata (89.2%), conjunctival vessels tortuosity (85.7%), corneal haze (67.8%), retinal vessels tortuosity (64.2%), anterior cataract (39.2%) and posterior cataract (28.5%). Prevalence for new elements are found: upper lid vessels toricity (96.4%) and micro-aneurysms (42.8%). At the end, micro-aneurysms (+82%), posterior cataract (+75%) corneal haze (+21%) anterior cataract (+17%) and retinal vessels tortuosities (+4%) evolved in prevalence and severity despite the fact that 68% of the patients were on ERT. Treated heterozygotes evolved more than other groups (p>0.05). Conclusion ERT does not seem to halt the clinical evolution of several ocular manifestations. Longer observational time and objective grading systems may be required to fully confirm these findings.
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Influence of the scleral lens and fluid reservoir thicknesses on residual astigmatism
Michaud, Langis; Courey, Gabriella; Université de Montréal. École d'optométrie (Dougmar Publishing Group, 2021-01-14)
Purpose This study aims to determine if lens or tear fluid reservoir thicknesses (LT/FRT) may influence the presence of residual astigmatism and participant’s visual acuity. Methods The study was a randomized, non-dispensing, prospective study. Empirically and randomly chosen participants were fitted with 4 combinations (350 and 250 um LT fitted with 250 and 350 um FRT) of 16 mm diameter scleral lenses, designed using a corneo-scleral profiler software (sMap 3D, Visionary Optics, US). Lenses haptics were kept spherical for all lenses. They were evaluated under a slit lamp, anterior segement OCT (objective fluid reservoir and lens thicknesses), topography over lenses and aberrometry, after 30 minutes of lens wear. Spherico-cylindrical refraction and logMar acuity were also assessed. Results Study population was composed of 24 participants aged 24.2 + 4.7 years old. Baseline refractive error was -2.3 + 1.6 D with -0.48 + 0.26 D of astigmatism. In vivo (OCT) lens A was 344.1 ± 15.4 um thick, fitted with a vault of 213.6 ± 42.4 um; Lens B was 346.2 ± 12.5/327.2 ± 44.8; Lens C was 260.3 ± 17.7/214.0 ± 40.6 um and Lens D was 262.2 ±13.2/330.8 ± 52.0 respectively. All lenses were found similarly decentered inferiorly by 0.10 to 0.15 um. BCVA was −0.32 + 0.08 (A), −0.21 + 0.10 (B), −0.28 + 0.08 (C), and −0.14 + 0.10 (D), compared to −0.25 + 0.08 (A), −0.11 + 0.10 (B), −0.23 + 0.06 (C), and −0.05 + 0.12 (D) when sphere only was compensated. Residual refractive astigmatism (RA = -0.50 to -0.75D) is found significantly higher based on the FRT (F=9.560; p=0.037) and not LT(F=0.429; p=0.522). There is no correlation between RA and over-k readings (Lens A r=-0.078, p=0.773; Lens B r=−0.073, p=0.788; Lens C r=−0.345, p=0.171; Lend D r=0.019, p=0.944). Higher order aberrations, mostly vertical coma, were found clinically significant but not statistically different between lenses (A= 0.350 + 0.032; B=0.382 + 0.053, C=0.329 + 0.044 and D=0.385+ 0.062; p=0.776) Conclusion This study proves that low level of RA may be found when scleral lenses are fitted on normal corneas. Its occurrence is related to the presence of high-order aberrations and less likely to lens flexure.
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Combien coûtent les thérapies oculaires les plus fréquemment prescrites par les optométristes québécois?
Althot, Chloé; Paré, Maxime; Bouchard, Jean-François; Tousignant, Benoît; Université de Montréal. École d'optométrie; Université de Montréal. École de santé publique. Département de médecine sociale et préventive (Association des optométriste du Québec, 2019)
Objectifs. Le coût d’une thérapie affecte l’adhésion au traitement. Peu de données existent pour aider les optométristes à incorporer ceci dans leurs décisions cliniques. Cette étude vise à quantifier les coûts totaux aux patients des médicaments et des thérapies oculaires les plus fréquemment traitées par les optométristes québécois. Méthodes. Étude descriptive. Recensement des 15 conditions oculaires les plus fréquemment traitées (Delphi, 16 optométristes experts) ; recensement des traitements standards des conditions (agents thérapeutiques et durée) ; sondage de pharmaciens québécois sur les prix totaux au patient (coût du médicament, honoraires et frais de service) ; calcul des coûts moyens des thérapies à partir du prix total moyen, de la combinaison des substances et de la durée des traitements, et du statut de couverture d’assurancemédicaments publique. Résultats. Les conditions oculaires les plus traitées par les optométristes requièrent souvent entre un et trois agents et durent entre une à quatre semaines. Le prix de vente total 2 moyen varie de (16 ± 3$) (chlorure de sodium 5% générique) à 132 ± 3$ (cyclosporine A 0,005%). L’acétate de prednisolone 1% (originale) coûte 65 ± 17$ et l’olopatadine générique 0,2%, 42 ± 2$. Le traitement pour un ulcère cornéen périphérique coûte 66$ avec la combinaison loteprednol 0,5% (original) et moxifloxacine 0,5% (originale) alors qu’avec les agents génériques couverts par l’assurance-médicaments publique (fluorométholone 0,1% et tobramycine 0,3%), il est de 11,42$ (578% moins cher). Discussion et conclusion. Le prix total des médicaments varie grandement selon les principes actifs et leur formulation (générique ou originale). Le coût total d’une thérapie pour un patient varie énormément selon les agents prescrits et le statut de couverture d’assurance-médicaments publique. En choisissant bien les médicaments, les optométristes peuvent réduire substantiellement les coûts aux patients et optimiser les chances d’adhésion au traitement.
Accès libre
La prévalence et les causes de la déficience visuelle dans la population en situation d'itinérance de la région de Montréal
Beaulieu, Kim; Yelle, Brittany; Etty, Marie-Christine; Michaelsen, Sonia; Druetz, Thomas; Samaha, Dan; Tousignant, Benoît; Université de Montréal. École d'optométrie (2020-04)
Contexte : Les populations marginalisées sont plus à risque de présenter des problèmes de santé. La santé oculovisuelle des personnes en situation d’itinérance est peu étudiée. Objectifs : Estimer la prévalence de déficiences visuelles, d’erreurs réfractives non corrigées et des pathologies oculaires chez les personnes en situation d’itinérance de Montréal et leur utilisation des soins oculovisuels. Méthodes : Dix ressources pour personnes en situation d’itinérance dans la région de Montréal ont été choisies par échantillonnage simple stratifié. À chaque lieu, après consentement, 10 participants ont été recrutés aléatoirement et soumis à une évaluation oculovisuelle détaillée (acuités visuelles ETDRS de présentation et avec trou sténopéïque, pression intraoculaire, examen rétinien mydriatique, autoréfractométrie post-mydriase et questionnaire). Résultats : Parmi les 95 participants, l’âge médian est de 49 ans (écart interquartile 38,0 – 56,5). La prévalence de déficience visuelle (acuité visuelle de présentation : meilleur œil < 6/12) est de 24,2% [IC 95%, 15,6-32,8%], contre 6% au Canada (p < 0,001). Après la mesure de l’acuité visuelle avec trou sténopéïque, cette prévalence chute à 5,2% [IC 95%, 0,7-9,7%]. Parmi ceux présentant une déficience visuelle, 12,6% [IC 95%, 5,9-19,3%] ont une cause uniquement réfractive non corrigée et 6,4% [IC 95%, 1,5-11,3%] présentent une pathologie oculaire (cataracte, glaucome ou autre). Finalement, 18,9% [IC 95%, 11,0-26,8%] ont accédé à des soins oculovisuels dans la dernière année, contre 43,8% au Canada (p < 0,0001) et 2,1% n’ont jamais eu d’examen oculovisuel. Conclusion : Ces données suggèrent que la prévalence de déficience visuelle dans la population itinérante montréalaise est élevée et que la majorité des causes sont corrigibles de façon réfractive. Malgré une prévalence de déficience visuelle plus élevée que dans la population canadienne, l’utilisation des soins oculovisuels par cette population est insuffisante. Ceci souligne l’importance d’adapter les modèles d’accès de soins à cette population.
Accès libre
Musculoskeletal disorders in optometrists and level of risk associated with optometric techniques
Di Meglio Lemieux, Vanessa; Généreux-de Guise, Camille; Brûlé, Julie; Tousignant, Benoît; Université de Montréal. École d'optométrie; Université de Montréal. École de santé publique. Département de médecine sociale et préventive (2019)
Accès libre
Prevalence of visual impairment and eye disease in Cañete, Peru
Brûlé, Julie; Tousignant, Benoît; Université de Montréal. École d'optométrie; Université de Montréal. École de santé publique. Département de médecine sociale et préventive (2019)

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