The combined influence of knowledge, training and experience when grading contact lens complications

Nathan Efron, Philip B. Morgan, Ritu Jagpal

    Research output: Contribution to journalArticlepeer-review


    Purpose: A study was conducted to evaluate the influence of knowledge, training and experience (clinical skills set) when assessing the severity of contact lens complications. Methods: Nine optometrists (who were in possession of a relevant clinical skills set) and nine 'non-optometrists' (subjects without the clinical skills set) were each invited to grade - to the nearest 0.1 increment - an image of each of 16 contact lens complications using Efron Grading Scales for Contact Lens Complications. This procedure was repeated 2 weeks later, yielding a total data base comprising 576 individual grading estimates. Results: The mean of the test and retest grading estimates was the same for the optometrists (2.8 ± 0.7) and the non-optometrists (2.6 ± 0.9) (F1,15,1 = 1.3, p = 0.26); that is, non-optometrists can grade accurately. Median grading reliability for optometrists (±0.41) was lower than (i.e. superior to) that for non-optometrists (±0.67) (p = 0.001). Non-optometrists tended to display a reluctance to grade by interpolation and to less reliably grade subtle clinical signs. Conclusions: When averaged over several attempts, non-optometrists will arrive at similar estimates of severity to optometrists when grading ocular complications of contact lens wear; however, they will do so less reliably. The relative contribution of the three attributes of the clinical skills set to grading performance is presently unclear. © 2003 The College of Optometrists.
    Original languageEnglish
    Pages (from-to)79-85
    Number of pages6
    JournalOphthalmic and Physiological Optics
    Issue number1
    Publication statusPublished - Jan 2003


    • Accuracy
    • Contact lens complications
    • Experience
    • Grading scales
    • Knowledge
    • Reliability
    • Training


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