Finnish Optometrists’ Competence to Recognize, Assess and Manage Trochlear Nerve Palsy

Abstract

Optometrists are primary eye care providers trained to recognize and manage various eye conditions. Optometrists can play a crucial role in early detection of eye diseases and referral for further evaluation. Trochlear nerve palsy is a condition characterized by vertical diplopia due to dysfunction of the trochlear nerve. Because diplopia can indicate serious neurological conditions, detection of trochlear nerve palsy by optometrists to facilitate timely referrals and care is essential. Optometrists' ability to identify specific neurological conditions may depend on the complexity of the condition, training, clinical skills, and expertise. Finnish optometrists' competencies and resource adequacy regarding ocular nerve palsies had not been studied before. The purpose of this cross-sectional study was to investigate Finnish optometrists’ and opticians’ self-assessed competence in related to recognizing, assessing, and managing trochlear nerve palsy. Additionally, the study aimed to identify the factors associated with optometrists’ competence in this area such as familiarity with test methods and resource availability. The overall aim was to examine whether the optometrists’ competence objectives in trochlear nerve palsy care are met, how optometrists perceive their clinical skills, what are the needs for development, and whether optometrists are willing to participate in additional training.

An online questionnaire was performed to investigate the self-assessed competence levels of Finnish optometrists and opticians regarding the recognition, assessment, and management of trochlear nerve palsy. The inclusion criterion was Finnish optometrists or opticians working in an eye clinic, hospital, or optical shop. Exclusion criteria were undergraduate optometry students or optometrists from other countries. The questionnaire was created based on articles concerning optometrists’ competence areas other than nerve palsies because none was found in the literature search. The level of competence was evaluated on a four-step Likert scale of 1=poorly, 2=moderately, 3=well, and 4=excellently. The data was collected during April-May 2024. The study tried to reach the basic group (all working Finnish opticians and optometrists) as comprehensively as possible by sharing a public link via the Finnish Professionals of Optometry (SOA) trade union and on social media channels used by Finnish optometrists and opticians. The data was analyzed using the SPSS program. Correlations between the background variables and the sum variables of competencies were analyzed with the chi-square test, likelihood ratio, and the Kruskal-Wallis test with a Bonferroni correction of the p-values. The results will be published in a separate article, and they can be utilized in competence development and education of optometrists in related to ocular cranial nerve palsies.