AWARENESS AND KNOWLEDGE OF SCLERAL LENS PRACTICE AMONG OPTOMETRISTS IN BIHAR
Main Article Content
Abstract
Background: Scleral lenses are specialty gas-permeable contact lenses that vault the cornea and rest on the sclera, creating a fluid reservoir that can improve optical quality and protect the ocular surface. Safe fitting requires technical knowledge, practical training and access to diagnostic resources. Regional evidence from Bihar is limited.
Objective: To assess awareness, item-level theoretical knowledge, reported practice patterns and perceived barriers related to scleral lens practice among optometrists in Bihar.
Materials and Methods: A descriptive cross-sectional online survey was conducted among qualified optometrists practicing in Bihar using a non-probability convenience sampling approach. A literature-informed 35-item questionnaire covering demographics, awareness, item-level theoretical knowledge, reported practice, complications and barriers was validated by six scleral lens practitioners using content-validity indices. Knowledge was analyzed through selected theoretical indicators and an open-ended utility item rather than as a single clinical-competency score. Data from 88 complete eligible responses were analyzed descriptively. Exploratory association analyses used Fisher's exact test or chi-square testing with effect sizes where appropriate.
Results: Among 88 respondents, 62.5% were aged 20-30 years, 70.5% were male, 60.2% held a Bachelor of Optometry degree, 68.2% had less than 5 years of practice and 63.6% worked in hospital-based settings. Overall, 75 respondents (85.2%) reported at least some awareness of scleral lenses and 47 (53.4%) reported full awareness. In the open-ended utility item, 42.0% demonstrated correct knowledge, 33.0% partial knowledge and 25.0% minimal knowledge. Selected technical knowledge was stronger: 77.3% correctly identified the purpose of central vault, and 73.9% identified high-Dk gas-permeable materials and all key design parameters. However, 44.3% had never fitted scleral lenses and only 10.2% reported regular fitting. The most common single barrier was lack of formal training (31.8%). Exploratory analyses did not show significant associations between experience and full awareness or between qualification and utility knowledge.
Conclusion: Surveyed optometrists in Bihar demonstrated partial but non-uniform awareness and selected areas of theoretical knowledge, while routine clinical fitting remained uncommon. The findings indicate a knowledge-to-practice gap and support structured hands-on training, mentorship, improved trial lens access and stronger referral pathways.
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