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Monocular Status and Protective Eyewear Use Among Patients in a University Retina Practice

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Posterboard#: A0447

Abstract Number: 3948 - A0447

AuthorBlock: Frances Wu1, Saras Ramanathan1
1Ophthalmology, UCSF, San Francisco, California, United States;

DisclosureBlock: Frances Wu, None; Saras Ramanathan, None;

Retina specialists manage a variety of conditions that can lead to severe irreversible vision loss. This study investigates the prevalence of monocular status as well as the rates of and factors associated with protective eyewear use among adult patients seen in an academic retina practice.

In this cross-sectional study, monocular patients were recruited during routine outpatient visits to the UCSF retina clinic. Inclusion criteria included age 18 years and over, best corrected visual acuity 20/200 or worse in one eye only, and duration of vision loss of at least 3 months. Patients were excluded if they had not seen an eye provider since onset of monocular status. Demographic information and the ophthalmic history and exam were obtained from the medical record. Participants completed a survey regarding duration of vision loss, quality of vision in the better eye, and knowledge and use of protective eyewear. Patients who did not report using protective eyewear were counseled on its importance and offered a referral to the UCSF optometry service.

Of 287 consecutive adults seen in the retina clinic, 49 (17.1%) met eligibility criteria. A total of 45 patients completed the survey, of which 18 (40.0%) recalled protective eyewear counseling and 14 (31.1%) reported its use. Use of protective eyewear was not significantly associated with age, gender, ethnicity, best obtainable visual acuity in either eye, duration of vision loss, or perceived vision in the better eye (all p>0.1). Monocular vision loss was associated with an external cause (phthisis, enucleation, and trauma) in 6/14 (42.9%) of patients who reported using protective eyewear compared to 4/31 (12.9%) of those who did not (p=0.03). Intraocular causes of vision loss included retinal degeneration, retinal detachment, intraocular malignancy, retinal vascular occlusion, uveitis, diabetic retinopathy, and macular hole.

In this study, 17% of adult patients evaluated in an academic retina setting had severe vision loss in one eye only. Monocular patients who reported using protective eyewear were more likely to have an external cause of vision loss compared to those who did not, though the reasons for this are unknown. Retina providers should be cognizant of monocular status and refer patients to obtain protective eyewear when appropriate.

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