Optimising optometric practice provided to people with age-related macular degeneration (AMD)

Intervention 1: Classification of Age-related macular degeneration and Risk Assessment Tool (CARAT) online intervention. Description: This arm will be assigned an online intervention (the CARAT tool) that will assist optometrists with calculating a patient’s risk of progression to late-stage AMD, based on patient risk factors and clinical signs. Participants (optometrists) will need to enter information regarding their patient’s risk factors (such as age, family history of AMD, current smoking status and presence of reticular pseudodrusen) and clinical signs (such as size of drusen, AMD pigmentary changes) which will assist in classifying the severity of AMD, calculating the risk of progression to late-stage AMD, and providing appropriate management advice to patients (including review periods). A link to a supporting document will provide participants with further information to assist with managing a patient with AMD. In-office use of the online tool should take the optometrist 2-3 minutes. It is intended to be used with the patient, towards the end of the clinical examination whilst discussing clinical management. The CARAT online tool and the supporting document were designed specifically for this project and are not generally available. Participants will not receive a summary of their input but are required to enter their management recommendations in their patient clinical records, as per standard practice. Intervention 2: : Classification of Age-related macular degeneration and Risk Assessment Tool (CARAT) paper-based intervention. This arm will be assigned a similar intervention to Arm 1, however it will be delivered in a paper-based format. Participants will be provided with a flowchart to use when managing a patient with AMD. The chart will begin with information regarding patient’s risk factors including age, family history of AMD, current smoking status and presence of reticular pseudodrusen. The second part of the chart provides optometrists with a flowchart to classify AMD severity based on clinical signs and leads to an appropriate management recommendation. Arm 2 will also be provided with the same supporting manual as Arm 1, but in a paper-based form. In-office use of the paper-based tool should take the optometrist about 2-3 minutes. It is intended to be used with the patient, towards the end of the clinical examination whilst discussing clinical management. The CARAT paper-based tool and the supporting documentation weres designed specifically for this project and are not generally available. Participants will not receive a summary of their input but are required to enter their management recommendations, in their patient clinical records, as per standard practice.