“Awareness of Ocular Signs of Systemic Diseases Among Non-Ophthalmic Physicians in Tertiary Care”
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Abstract
Background
Ocular signs often appear before systemic symptoms are evident, offering an early window for detection. In tertiary care settings, non-ophthalmic physicians are often the first to encounter these patients. Limited awareness and inconsistent referral practices may cause a delay in diagnosis and increase the risk of irreversible visual impairment.
Objectives
To assess the level of awareness, knowledge, and referral practices of non-ophthalmic physicians regarding ocular manifestations of systemic diseases in a tertiary care centre in South India, and to identify barriers and training needs.
Methods
A descriptive cross-sectional study was carried out at a tertiary care centre among 208 non-ophthalmic doctors. A structured pre-validated study questionnaire was used as a study instrument. In addition to the level of awareness, the questionnaire included demographic details, questions about ocular signs in systemic disease, the referral practices of physicians, confidence in identifying ocular signs, and the training preferred by physicians. Awareness was categorized as adequate (≥75%), moderate (50–74%), or inadequate (<50%). Descriptive and inferential statistical analyses were performed using SPSS version 25.0, with a significance threshold of p<0.05.
Results
Almost all participants recognized diabetic retinopathy as a common ocular complication (95.67%) and advised screening at diagnosis of type 2 diabetes mellitus (100%), whereas 76.44% advised earlier screening in type 1 diabetes mellitus. The ability to recognize manifestations of diabetic retinopathy, such as retinal haemorrhages (75.96%), ocular tuberculosis (68.75%), and drug toxicity, was moderate.
Poorly recognized autoimmune ocular manifestations are uveitis (38%). Almost all the physicians (95.67%) carry out basic eye examination, while 85.58% have found a systemic disease based on ocular signs. Nonetheless, at diagnosis, only 25% of the hypertensive patients were referred to an ophthalmologist.
Conclusion
Though the knowledge of common ocular-systemic associations was good, the deficiencies identified in knowledge about autoimmune and drug-induced manifestations were noteworthy. In the same way, the practice pattern was acknowledged only as moderate with low confidence levels and an unsatisfactory referral pattern. Therefore, it is to be noted that, at the undergraduate level, there is insufficient ophthalmology training. There is also a need for interventions at both the individual and interdisciplinary levels to help close the gaps that still exist in diagnosing these conditions.