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mx9yMwIM37TyX9NHPJRUYen9fhfMc7V6JiXA6qqH9uyTrqx6J7aJkNKQEgIFSd

An investigation of the extent of use of lissamine green in optometry and contact lens practice in the UK and Ireland; and the factors influencing its use of lack of use.

You are being invited to take part in a research study. Before you decide whether or not to take part, it is important for you to understand why the research is being done and what it will involve. Please take time to read the following information carefully and do not hesitate to ask questions if there is anything that is not clear or if you would like more information. This project forms part of the BSc (Hons) Optometry programme. Thank you for taking the time to consider this study. 

What is the purpose of the study?  

Dry eye is a common problem for many patients who consult their local optometry practice. Symptoms include red eyes, grittiness, itchiness, burning, watery eyes and a general sense of the ocular irritation and discomfort. In 2017, the findings of the Tear Film & Ocular Surface Dry Eye Workshop II (TFOS DEWS II) were published evaluating the epidemiology, aetiology, mechanisms and the management and therapy for dry eye disease. As a result, Lissamine Green, an ocular dye, was advocated in the diagnosis of dry eye. Nonetheless, there continues to be some confusion and controversy over it use or potential use within the UK; and whether this is supported by the regulatory and other professional bodies providing legal indemnity cover for optometrists.  

This uncertainty stems from concern raised previously over the legal status of another widely used ocular dye called fluorescein. Fluorescein strips have long been regulated as medicines in the UK, but they are regulated as medical devices in much of the rest of the EU. In response to lobbying from the profession, the Medicines & Healthcare Products Regulatory Agency (MHRA) has permitted the supply of CE-marked medical device fluorescein strips to the UK market and a consensus statement by the main professional bodies has agreed it is in patients’ interests for optometrists to continue to use fluorescein in practice.  

Despite a similar position being evident with lissamine green strips, and CE-marked strips being available, no legal or professional consensus opinion had been forthcoming, until very recently, which has led to lack of clarity regarding its legal and professional use. This is in contrast to it being widely advocated in the latest research as beneficial in the diagnosis of dry eye and therefore potentially in the patients’ interest.

 Why have I been invited to take part? 

You have been invited to participate in this study because you are an optometrist or contact lens optician 

 Do I have to take part? 

Consent will be indicated by submission of the questionnaire. Because you will complete the questionnaire anonymously, you will not be able to withdraw from the project once your questionnaire is submitted. 

 Will my taking part in this study be kept confidential? 

All data is anonymised and will be stored securely.  

Who has reviewed this study? 

This study has been reviewed by the School of Biomedical Sciences Filter Ethical Committee of the University of Ulster. 

Contact details (Student)

Christina Martin

Email: martin-c59@ulster.ac.uk

Contact Details (Supervisor)
Arnold Cochrane
School of Biomedical Sciences
Ulster University
Coleraine
BT52 1SA
Tel +44 (0)28 7012 3034
E-Mail: ajs.cochrane@ulster.ac.uk

Please select which of the following fields you work in:

* must provide value

Optometrist

Contact Lens Optician

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Are you:

* must provide value

Male

Female

Other/ prefer not to say

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What area of the UK or Ireland are you based?

* must provide value

London

South East

Scotland

North West

West Midlands

South West

East

Yorkshire & the Humber

East Midlands

Wales

North East England

Northern Ireland

Republic of Ireland

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How long are you qualified in your field?

* must provide value

Less than 5 years

6 - 10 years

11 - 15 years

16 - 20 years

21 - 25 years

More than 25 years

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What percentage of the working week do you see contact lens patients?

* must provide value

0 - 20%

21 - 40%

41 - 60%

61 - 80%

81 - 100%

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What percentage of the week do you carry out dry eye investigations?

* must provide value

0 - 20%

21 - 40%

41 - 60%

61 - 80%

81 - 100%

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Do YOU use lissamine green in your practice for assessment of dry eyes?

* must provide value

Yes

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If you do not use it, why not? (Tick main reason only)

* must provide value

None kept by practice

Never thought about using it

No experience of using this dye

Insufficient evidence base for its use

Not covered by legal indemnity insurance

Lack of consensus statement (until recently) from professional bodies

Other (Please State):

Not applicable

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If you selected 'other' to the last question, please state why:

Prior to completing this questionnaire, were you aware of the legal position of lissamine green and that, until very recently, there was no consensus statement from the General Optical Council regarding its use?

* must provide value

Yes

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What brand(s) do you use?

* must provide value

I Dew Green

Biotech

Green Glo

Optitech

Green Touch

Other (Name):

Not applicable

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If you answered other, please state the name:

How do you apply it?

* must provide value

No specific set routine

Use one strip and wet with saline

Use two strips simultaneously and wet with saline

Wet the strip with saline, with the whole drop retained on the strip for at least 5 seconds to elute the dye

Other (Please describe):

Not applicable

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Please complete if you selected 'Other' to the previous question:

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Do you feel lissamine green is an effective aid in monitoring and diagnosing dry eye? Rate your satisfaction on the scale below:

Change the slider above to set a response

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You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.